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Research Article

ArticleID :IJNR/2024/10/01/01

Awareness on Scabies among Adults Residing in Rural Areas - A Descriptive Study

Issue No. 01 (Jan-Mar)

Authors: Jyoti Chaudhari, Celina Thomas, Pranita Pati, Snehal Patil, Sonali Bhosale, Triveni Salunke, Divya Pathak

Background: Scabies is one of the most common neglected skin diseases seen in developing countries. Awareness of disease and hygienic practices can drastically reduce the incidence and related consequence in later years of life. With this view study is undertaken to assess the awareness of scabies and its prevalence in the rural community of Raigad district.

Methodology: A descriptive research design with a total enumeration sample was undertaken for the study. The adults age and/above 20 years, residing in Dhodhani village of Raigad district and willing to participate were chosen for data collection using researcher made pre-validated semi structured interview schedule. A total sample was 48 adults who were able to understand and communicate in local language.

Results: Out of 48 participants, 39 participants (81.25%) have heard about scabies. The total awareness score of participants regarding sign and symptoms and consequences of scabies was 47.6%. None of the participants were knowing all sign and symptoms, and consequences of scabies of health and productivity. The total awareness score regarding etiology, predisposing factors and measures for prevention were only 35.4% and about management of scabies the score was 51.6%. The mean awareness score was 44.9%. The survey resulted into finding out of 2 cases of scabies in the community.

Conclusion: From this study, researchers concludes that majority (81.25%) participants has heard about scabies, however understanding of scabies as a skin disease, its causes, sign and symptoms, and prevention was inadequate. There is great need for development of consciousness about scabies to protect self.

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Research Article

ArticleID :IJNR/2024/10/02/01

Laughing for Well-Being: Investigating the Impact of Laughter Therapy on Stress Levels among the Elderly Population

Issue No. 02 (Apr-June)

Authors: Rahul K. Damor

Background: The aim of the study was to evaluate the impact of laughter therapy on the degree of perceived stress experienced by elderly residents of a particular assisted living facility.

Methods: A pre-experimental, one-group, pre-test–post-test research design was employed. The technique of purposeful sampling was applied. A selection of thirty samples was made. The study’s participants were senior citizens living in retirement communities in a designated district.

Findings: During the pretest, two samples (6.66%) reported low stress, twelve samples (40%) reported moderate stress, and sixteen samples (53.33%) reported high perceived stress. The mean difference was determined to be 11.7, with the mean pre-test score being 26.4 and the mean post-test score being 14.7. It demonstrates that there was a substantial difference between the mean pre-test and post-test scores. Thus, following the application of laughter therapy, the samples’ perceived stress levels decreased.

Conclusion: Laughter therapy is beneficial in lowering stress levels in the elderly population, according to this study. Thus, we can conclude that laughter therapy is beneficial for stress relief.

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Research Article

ArticleID :IJNR/2023/09/01/01

Knowledge and Lifestyle Practices Regarding Coronary Artery Disease among Women

Issue No. 01 (Jan-Mar)

Authors: Reena Issac

Introduction: Coronary artery disease (CAD) is one of the leading causes of death all over the world. Good knowledge and lifestyle practices reduce the incidence of CAD.

Objectives: The objectives of this study was to determine the knowledge and lifestyle practices regarding CAD among women and also to identify the association of knowledge and lifestyle practices with selected socio-personal variables.

Methodology: A descriptive survey design was employed to collect self-reported data from 102 women (35–55 years) residing in two communities in Kerala, India.

Results: Major part of the study participants (35.3%) was between 35 and 39 years, 63.7% educated up to 10th standard, and 55.9% were household workers. Majority of the women had good knowledge, 8.8% had excellent, 28.4% had average, and 17.6% had poor knowledge. The area-wise analysis showed comparatively poor mean percentage of knowledge about risk factors (52.8%) diagnosis and treatment (53.5%). Better mean percentage was observed for meaning of CAD (77.35%), signs and symptoms (83%), and lifestyle modifications (75.5%). The study showed 69.6% of women had good lifestyle practices, 19.6% had very good, and 10.8% had average lifestyle practices. None of them had either excellent or poor lifestyle practices. Area-wise analysis of lifestyle practices showed that a lower mean percentage was noted with dietary practices (62.9%) and physical activity (57.3%) compared to habits (86.7%) sleep, and rest and stress reduction measures (77.2%). The level of education and knowledge is associated significantly (P < 0.001).

Conclusion: Proper awareness about the disease helps to prevent CAD.

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Research Article

ArticleID :IJNR/2019/05/01/01

A Study to Assess the Effect of Chilled Cabbage Leaves Application on Breast Engorgement among Post-natal Mothers Admitted in Selected Hospital of Navi Mumbai

Issue No. 01 (Jan-Mar)

Authors: Rajashree Salgaonkar

Introduction: Breast engorgement is a common problem among post-natal women worldwide. Engorgement is a unpleasant, painful condition in which there is swelling and distension of the breasts usually in the early days of the initiation of lactation. Breast engorgement can be relieved by various non-pharmaceutical interventions. Chilled cabbage leaves usage is one of them. 

Aim: The present study was conducted to reduce the level of breast engorgement by the use of chilled cabbage leaves. 

Materials and Methods: A quasi-experimental design was used for this study. The study was performed on 40 post-natal mothers of the post-natal ward of a selected hospital, of Navi Mumbai. Storr scale (1988) used for assessing breast engorgement before and after the application of chilled cabbage leaves. 

Results: The study results show that there was a reduction in breast engorgement after the intervention and statistically verified. 

Conclusion: The analysis of data showed that using chilled cabbage leaves there is a significant reduction in breast engorgement.

How To Cite this Article

Salgaonkar R. A Study to Assess the Effect of Chilled Cabbage Leaves Application on Breast Engorgement among Post-natal Mothers Admitted in Selected Hospital of Navi Mumbai.. Int J Nur Res. 2019; 5(1): 1-4.

Research Article

ArticleID :IJNR/2019/05/01/02

Prognostic utility of epidermal growth factor receptor (EGFR) expression in prostatic acinar adenocarcinoma

Issue No. 01 (Jan-Mar)

Authors: Atif Ali hashmi, Shumaila Kanwal Hashmi, Muhammad Irfan, Huda Asif, Laila Nisar, Maheen Naeem, Erum Yousuf Khan, Samina Baloch and Naveen Faridi

Background: Epidermal growth factor receptor (EGFR) is potential prognostic biomarker expressed in many human cancers. Prognostic significance of EGFR immunohistochemical expression has not been established in prostatic acinar adenocarcinoma, therefore we aimed to evaluate the frequency of expression of EGFR in prostatic adenocarcinoma and its association with other prognostic parameters.

Methods: The study included 123 cases of biopsy proven prostatic acinar adenocarcinoma treated at Liaquat National hospital, Karachi from January 2013 till December 2017. Paraffin blocks of all cases were retrieved; sections were cut and stained with haematoxylin and eosin. Pathologic characteristics including tumor quantification, WHO grade group, gleason score, perineural and lymphovascular invasion were evaluated. EGFR immunohistochemistry (IHC) was performed on all tissue blocks.

Results: Mean age of the patients included in the study was 69.05±8.68years. High gleason scores i.e. 8 & 9 were noted in 22% (27 cases) and 22.8% (28 cases) respectively. Similarly, 22.8% (28 cases) showed WHO grade group 5. 52.8% (65 cases) had > 50% tissue involvement by carcinoma and perineural invasion was seen in 37.4% (46 cases). Positive EGFR expression was noted in 18.7% (23 cases), while 81.3% (100 cases) showed negative EGFR expression. Significant association of EGFR expression was noted with gleason score (p-value = < 0.001), WHO grade (p = < 0.001), tumor quantification (p = 0.007) and perineural invasion (p = < 0.001). Moreover, significant association of EGFR expression was also seen with disease recurrence and Her2neu over expression. Patients with low gleason scores (score 6 and 7) and lower grade group (1, 2 & 3) were less likely to have positive EGFR expression as compared to patients with high gleason score (score 9) and higher grade group (5). Similarly, patients with perineural invasion were more likely to have positive EGFR expression.

Conclusion: We found a relatively low EGFR expression in our patients with prostatic adenocarcinoma; however, its association with poor prognostic parameters like high gleason score, higher grade group, perineural invasion, higher tissue involvement by cancer and disease recurrence signifies its importance as a prognostic parameter in prostatic acinar adenocarcinoma.

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Review Article

ArticleID :IJNR/2019/05/01/03

Splicing isoform-specific functional genomic in cancer cells

Issue No. 01 (Jan-Mar)

Authors: Jean-Philippe Brosseau

Alternative splicing is a regulated process whereby one gene can generate multiple mRNA isoforms susceptible to be translated into protein isoforms of various functions. Several publications report the aberrant expression of splicing isoforms in cancer cells and tissues. However, in most cases, their function remains to be established. In this review article, I will discuss the molecular tool available to perform isoform-specific functional genomics, the methodologies to quantify their effectiveness and the resulting isoform-specific phenotype in human cancer cell lines.

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Others

ArticleID :IJNR/2019/05/01/04

Use of interval-censored survival data as an alternative to Kaplan-Meier survival curves: studies of oral lesion occurrence in liver transplants and cancer recurrence

Issue No. 01 (Jan-Mar)

Authors: Agatha S. Rodrigues, Vinicius F. Calsavara, Felipe I. B. Silva, Fábio A. Alves and Ana P. M. Vivas

After undergoing liver transplantation, children are susceptible to oral lesions due to immunosuppressant drugs that are needed to maintain the transplant. In this context, it is important to understand how disease characteristics and age at transplantation influence the development of these lesions. Monitoring of lesions begins after transplantation and children are usually observed by a specialist in stomatology at periodic visits. Consequently, lesion development is estimated to occur between two observed times, and this is characterized as interval-censored data. However, in clinical practice, it is common to assume the moment of observation as the time of event occurrence, thereby excluding interval-censored data. Here, we discuss the impact of excluding interval-censored mechanisms in statistical analyses by using simulation studies to consider differences in sample sizes and amplitudes between observed intervals. Then, application studies are presented which use a data set from a prospective study that was conducted to investigate oral lesions in patients after liver transplantation at the A.C.Camargo Cancer Center in Brazil between 2013 and 2016 and a data set involving recurrent ovarian cancer in patients diagnosed with high-gradeserous carcinoma at the A.C.Camargo Cancer Center between 2003 and 2016.

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Review Article

ArticleID :IJNR/2019/05/01/05

Special series on “effects of board games on health education and promotion” board games as a promising tool for health promotion: a review of recent literature

Issue No. 01 (Jan-Mar)

Authors: Mutsuhiro Nakao

Board games are played by moving game pieces in particular ways on special boards marked with patterns. To clarify the possible roles of board game use in psychosomatic medicine, the present review evaluated studies that investigated the effects of this activity on health education and treatment. A literature search conducted between January 2012 and August 2018 identified 83 relevant articles; 56 (67%) targeted education or training for health related problems, six (7%) examined basic brain mechanisms, five (6%) evaluated preventative measures for dementia or contributions to healthy aging, and three (4%) assessed social communication or public health policies. The results of several randomized controlled trials indicated that the playing of traditional board games (e.g., chess, Go, and Shogi) helps to improve cognitive impairment and depression, and that the playing of newly developed board games is beneficial for behavioral modifications, such as the promotion of healthy eating, smoking cessation, and safe sex. Although the number of studies that have evaluated board game use in terms of mental health remains limited, many studies have provided interesting findings regarding brain function, cognitive effects, and the modification of health-related lifestyle factors.

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Research Article

ArticleID :IJNR/2019/05/01/06

Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators

Issue No. 01 (Jan-Mar)

Authors: Toru Takahashi, Fukiko Sugiyama, Tomoki Kikai, Issaku Kawashima, Siqing Guan, Mana Oguchi, Taro Uchida and Hiroaki Kumano

Background: Mindfulness-based interventions are increasingly being implemented worldwide for problems with depression and anxiety, and they have shown evidence of efficacy. However, few studies have examined the effects of a mindfulness-based group therapy based on standard programs for depression and anxiety until follow-up in Japan. This study addresses that gap. Furthermore, this study explored the mechanisms of action, focusing on mindfulness, mind wandering, self-compassion, and the behavioral inhibition and behavioral activation systems (BIS/BAS) as possible mediators.

Methods: We examined 16 people who suffered from depression and/or anxiety in an 8-week mindfulness group therapy. Measurements were conducted using questionnaires on depression and trait-anxiety (outcome variables), mindfulness, mind wandering, self-compassion, and the BIS/BAS (process variables) at pre- and post-intervention and 2-month follow-up. Changes in the outcome and process variables were tested, and the correlations among the changes in those variables were explored.

Results: Depression and anxiety decreased significantly, with moderate to large effect sizes, from pre- to postintervention and follow-up. In process variables, the observing and nonreactivity facets of mindfulness significantly increased from pre- to post-intervention and follow-up. The nonjudging facet of mindfulness and self-compassion significantly increased from pre-intervention to follow-up. Other facets of mindfulness, mind wandering, and the BIS/BAS did not significantly change. Improvements in some facets of mindfulness and self-compassion and reductions in BIS were significantly correlated with decreases in depression and anxiety.

Conclusions: An 8-week mindfulness group therapy program may be effective for people suffering from depression and anxiety in Japan. Mindfulness and self-compassion may be important mediators of the effects of the mindfulness group therapy. Future studies should confirm these findings by using a control group.

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Review Article

ArticleID :IJNR/2019/05/01/07

Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review

Issue No. 01 (Jan-Mar)

Authors: Nagisa Sugaya, Tomohiro Shirasaka, Kenzo Takahashi and Hideyuki Kanda

Previous large-scale studies suggest that internet gaming disorder (IGD) among children and adolescents hasbecome an important public concern. Minors are known to be particularly susceptible to problematic internet gaming use owing to age-related underdevelopment of cognitive control. It has been shown that precursors of addictions appear during adolescence; therefore, prevention efforts must be established targeting minors who have their first experience with addictive substances and behaviors during pubescence. Since the DSM-5 classification of IGD in 2013, studies on IGD have drastically increased in number. Thus, we performed an updated review of studies of IGD in children and adolescents to assess the clinical implications of IGD. The search included all publication years, using PubMed, MEDLINE, and PsycINFO. Across studies, the presence of IGD had a negative effect on sleep and schoolwork in minors. Additionally, family factors, including the quality of parent-child relationships, were important social factors in minors with IGD. Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum. Persistent pathological online game use from childhood may aggravate abnormal brain function; therefore, preventive care and early intervention are increasingly important. Although extant research supports the effectiveness of cognitive behavioral therapy for minors with IGD, effective psychological intervention for minors with IGD is an urgent issue that requires further research. This review, which presents updated findings of IGD in minors, is expected to contribute to the development of future research and be useful in clinical practice in the field of child and adolescent psychiatry.

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Research Article

ArticleID :IJNR/2019/05/02/01

A Study to Access the Effect of Planned Teaching in Relation to a Selected Aspect of Pregnancy-Induced Hypertension among Antenatal Mothers at a Government Hospital Mumbai

Issue No. 02 (Apr-June)

Authors: Sujata Raosaheb Palve

Background: Hypertension is one of the common complications and contributes significantly to perinatal mortality and morbidity. Hypertension is a sign of underlying pathology which may be pre-existing or appear for the first time during pregnancy. The identification of the clinical entity and effective management plays a significant role in the outcome of pregnancy, both for the mother and the baby. 

Aim: The main aim of the study was to assess the effect of planned teaching on knowledge regarding pregnancy-induced hypertension (PIH) among antenatal mothers. 

Methods: The study was conducted on conveniently selected 30 samples of antenatal mothers in Government Hospital, Mumbai. The data collection process started from April 11, 2010, to May 2, 2010, after getting the required permission from the respective authorities. Data were collected by sociodemographic variables and self-structured knowledge questionnaire. Collected data were analyzed by descriptive and inferential statistics. 

Results: The study finds the results that the knowledge on the concept of hypertension, etiology and risk factors, signs and symptoms, investigations, exercise-related management of PIH, dietary management, prevention, and complications during PIH was significantly higher after teaching program in comparison to before teaching program. Overall knowledge of antenatal mothers to manage hypertension was significantly higher post-test in comparison to pre-test. Thus, results indicated that the planned teaching had a significant impact on knowledge regarding PIH among antenatal mothers. 

Conclusion: In this study, the post-test knowledge score was associated with education and occupation.

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Research Article

ArticleID :IJNR/2019/05/02/02

A Study to Assess the Anxiety and Coping Strategies among First-year B.Sc. Nursing Students in Selected Institutes of Navi Mumbai

Issue No. 02 (Apr-June)

Authors: Vishal Powar

Background: Students are subjected to different kinds of stressors, such as the pressure of academics with an obligation to succeed, an uncertain future, and difficulties of integrating into the system. 

Aim: A descriptive study was conducted in selected nursing institutes of Maharashtra to assess stress level and coping strategies among nursing students. A total of 100 1st year nursing students participated in the study. Likert scale was used to assess stress level. 

Results: Results revealed that 4% of the samples had severe anxiety, 40% had moderate anxiety, 48% had mild anxiety, and 8% of samples have no anxiety. Anxiety levels were significantly higher in females in comparison to males (30.79±7.47 vs. 28.65±7.98; P = 0.036). Coping behavior was comparable in females in comparison to males (53.70±4.62 vs. 53.29±4.40;P = 0.768). 

Conclusion: Strengthening nursing students’ positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches may be useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.

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Research Article

ArticleID :IJNR/2019/05/02/03

A Descriptive Study to Assess the Measures Adopted by Mothers to Reduce Behavioral Problems in Children Aged 6–12 Years in Selected Urban Areas of District Shimla, Himachal Pradesh

Issue No. 02 (Apr-June)

Authors: Shashi Kiran Dautoo, B. Rekha

Aim: This study aims to assess the measures adopted by mothers to reduce behavioral problems among children in selected urban areas. 

Methodology: Quantitative research approach and descriptive research design were applied. The research was conducted in the urban areas of Sanjauli, Shimla District, Himachal Pradesh. Sample size was 200 mothers and purposive sampling technique was used. 

Results: The results of the present study reveal that majority of mothers adopted the measures to reduce behavioral problems in children for temper tantrum was 11.5% avoided situation likely to stimulate the child, for nail biting 11.5% kept hands busy and cut the nails of child, for thumb-sucking 10.5% those praised for behavior change and kept hands busy, for enuresis (bed wetting) 12.0% made the child void before bedtime and reward for dry nights, for stammering 3.0% avoided stress and practiced speech training, for school phobia 8.5% of mothers adopted measures like praise for regular attendance at school, for anorexia nervosa 2.0% of mothers supervised meals and snacks and monitored the weight, for bulimia nervosa 1.5% avoided over feeding the child and monitor the weight, for breath holding spells 1.0% used distractive methods, stay calm, provide safe environment, and provide proper ventilation, for aggressiveness 27.0% tried anger management, for pica 13.0% gave positive reinforcement and kept the child away from mud, clay, chalks, etc., for somnambulism (waking in sleep) 6.5% kept close supervision, avoided bunk bed, and stayed most of the time with the child, for somniloquy (talking in sleep) 9.5% made sleep schedule and avoided emotional stress, for bedtime fears and nightmares 9.0% avoided scary television shows, and for lying 26.5% of mothers shared their values, whereas for shyness 19.0% of mothers stay with child in social situations. 

Conclusions: The study results show that measures adopted followed by mothers to deal with behavioral problems of their children that 197 (98.5%) mothers, the measures adopted level followed by mothers were “poor” and 3 (1.5%) mothers were followed average measures.

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Research Article

ArticleID :IJNR/2019/05/02/04

A Study to Assess Knowledge, Attitude, and Practices of Antenatal Care among Antenatal Women in Selected Rural Area of Haryana and Punjab State

Issue No. 02 (Apr-June)

Authors: Jaideep Herbert, Ancy Mathew, K. Jijo, Daniel Jadhav

Background: Antenatal care (ANC) is the care of the women during pregnancy. The primary aim of ANC is to achieve a healthy mother and a healthy baby at the end of pregnancy. The objectives of ANC are to promote, protect, and maintain the health of the mother during pregnancy. ANC helps to detect high-risk cases, to foresee complications, and to remove anxiety and dread associated with delivery. At the country level, two countries account for a third of global maternal deaths; India at 17% (50,000) and Nigeria at 14% (40,000). 

Methodology: The study was conducted after verbal consent from the participants. The study was designed as a cross-sectional study. The study populations were pregnant women residing in rural areas of Haryana and Punjab. Three hundred pregnant females recruited randomly women were questioned regarding obstetric health history during home visit. A total of 20 questions were framed on the knowledge regarding various aspects of ANC and other questions were regarding practices and attitude related to ANC. 

Results: The knowledge, attitude, and practices (KAP) study was conducted in a rural area of the state of Punjab and Haryana about ANC among pregnant women. It was found that knowledge, practices, and positive attitude about ANC among pregnant women score for knowledge was 64%, score for positive attitude was 79.66%, and score for ANC practices was 67%. 

Conclusions: Considerable gaps were found in the KAP regarding ANC among antenatal women. Literacy is an important factor in the utilization of ANC services. To improve community, spousal and family awareness of ANC, information, education, and communication activities should be increased on ANC through community campaign, mass media, and digital phones.

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Research Article

ArticleID :IJNR/2019/05/02/05

A Study to Assess the Prevalence of the Risk Factors of Coronary Artery Diseases among Women in Guwahati, Assam

Issue No. 02 (Apr-June)

Authors: Sijagurumayum Rashmi, Bijaya Thongam, Unmona Borgohain

Aim: The aim of the study was to assess the risk factors for coronary artery disease among women in Guwahati.

Materials and Methods: Quantitative research approach was used, and descriptive design was adopted in the study. The samples were collected using purposive sampling technique from 100 women, who were in the age group of 30–65 years, residing in Guwahati, Assam, and who fulfill the inclusion criteria. Semi-structured questionnaire was used to assess the prevalence of risk factors of coronary artery disease and biophysiological measurement to measure the body mass index (BMI) and blood pressure (BP). 

Results: It was found that 16% of them were having systolic BP more than 140 mm of mercury, 53% do not perform exercise, and only 15% performed yoga. Nearly 57% of them express that they have stress. Nearly 45% of them were having BMI more than 25 kg/m2. There was a statistically significant association of risk factor (BP) with age only and also a statistically significant association of risk factor (stress) with education and occupation. Finally, there was also a statistically significant association of risk factor (performance of exercise) with demographic characteristics, i.e., age, education, and occupation at 0.05 level of significance. However, there is no association of risk factor (BMI range) with any of the demographic variable. 

Conclusion: It was concluded that the risk factor for coronary artery disease was common among the women in Assam and since most of the risk factors were modifiable, timely intervention can help in reducing morbidity and mortality due to this disease.

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Research Article

ArticleID :IJNR/2019/05/02/06

An Exploratory Study to Assess the Knowledge and Attitude Regarding Universal Precautions about Hepatitis B among Staff Nurses in Selected Hospitals, Punjab

Issue No. 02 (Apr-June)

Authors: Kiranjit Kaur

Background: The knowledge of nursing staff regarding hepatitis B virus (HBV) when their daily activities will be closely related to patients’ body fluids plays a vital role in minimizing the risk of acquiring HBV infection. 

Objective: We aimed to assess the knowledge regarding HBV infection among nursing staff. 

Materials and Methods: A descriptive cross-sectional study was conducted using a structured self-administered questionnaire among the nursing staff in Tagore Hospital, Jalandhar. Descriptive statistics was used to analyze the data. Results: Most (51%) of staff nurses had good knowledge followed by 44% who had excellent knowledge and few (5%) staff nurses with average knowledge score regarding universal precautions about hepatitis B. No staff nurse had poor knowledge score. All of the (100%) staff nurses had desirable attitude regarding universal precautions about hepatitis B. 

Conclusion: The staff had good knowledge regarding HBV infection and its preventive aspect.

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Research Article

ArticleID :IJNR/2019/05/02/07

A Descriptive Study to Assess the Level of Compassion Fatigue among Nurses Working in Dr. L. H. Hiranandani Hospital

Issue No. 02 (Apr-June)

Authors: Elizebeth Thomas, Capt. Valsa Thomas, Soniya Susan Varghese

Aim: The study aimed to identify the level of compassion fatigue among the nurses and to correlate the level of compassion fatigue with demographic variables. 

Materials and Methods: The study was conducted on 200 staff nurses working in Dr. L. H. Hiranandani Hospital. The design used for the study is descriptive research design. Samples selected using non-probability convenient sampling technique. Tool used for the study is structured questionnaire. 

Results: Nurse creates a healing environment for patients and relatives with their daily interaction and technical skills. Primary task as helping professional is to meet the physical and emotional needs of the patient. Although compassion fatigue is a treatable problem, it causes severe negative effect on nurse’s professional as well as personal life. To prevent this, we need to understand the early signs and symptoms of compassion fatigue. Compassion fatigue remains significant concerns in nursing, affecting both individuals and organizations. There are many strategies to prevent themselves from compassion fatigue. Compassion fatigue plays an important role in the professional outcome of the nurses. The data collected from staff nurses working in Dr. L. H. Hiranandani Hospital show average level of compassion fatigue for majority of the nurses 84% have average level of compassion fatigue and 16% of nurses show high level of compassion fatigue. 

Conclusion: The prevention of compassion fatigue starts from self-care. However, most of the nurses put their needs at last. Organizations should provide a supportive work environment, good opportunities, and guidelines for the nurses to work efficiently.

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Research Article

ArticleID :IJNR/2019/05/02/08

Effectiveness of Planned Teaching Program Regarding Malnutrition on Mother of Children between 6 Months and 36 Months in Urban Area

Issue No. 02 (Apr-June)

Authors: Amita Joseph, Bharati Batra

Introduction: Malnutrition is a worldwide problem today. The main target of undernutrition is the preschooler, pregnant, and nursing mothers. It is estimated that about 170 million children “under-five” year of age, i.e., 30% of worlds children are malnourished in terms of being underweight, over 2/3rd of these malnourished children belong to Asia. Aim: A study to assess the effectiveness of planned teaching program on the knowledge of mothers of 6–36-month children on malnutrition in selected Anganwadi of Indore. 

Materials and Methods: This was a community-based study compromising of 50 mothers purposively selected. Data were collected by administering structured knowledge questionnaire and after that planned teaching program and post-test was taken after 7 days. 

Results: The total mean of pre-test was 9.5. Most of the subject had 32 (64%) average knowledge and 5 (10%) subjects have good and only 13 (26%) belong to poor. After administration of planned teaching program regarding malnutrition, the total mean of post-test was 14.06. This shows that there is gain in knowledge. Most of the subject that is 7 (14%) average remaining respondent had good knowledge 43 (86%). The mean post-test knowledge is 14.06 which is higher than pretest 9.5, the actual gain of knowledge is 4.56 and computed ‘t’ value (t50 = 15.39) is more than tabled value (t50 = 1.671) at the level of 0.05 thus indicated highly significant difference. 

Conclusion: The finding of this study indicates that planned teaching program on malnutrition appears to be effective in improving knowledge and practice of mothers of 6–36-month children relating to feeding and caring behaviors. Increase in the knowledge definitely showed a positive effect on the health of the child.

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Research Article

ArticleID :IJNR/2019/05/02/09

Effectiveness of Computer-assisted Teaching Program on Malnutrition and its Prevention in Under-five Children among Adolescents Studying in Selected Pre-university College, Bengaluru

Issue No. 02 (Apr-June)

Authors: Idreese Ahmad Parry, Syed Shahid Siraj, Syed Arifa

Introduction: In developing countries, malnutrition among children is a major public health issue. It is one of the most serious global risk factors for illness and death. Malnutrition during children has an impact later in life as it is associated with significant functional impairment, reduced work capacity, and decreased economic productivity. Malnourished children are more likely to suffer from delayed psychological development, poor school performance, and lower intellectual achievements.

Aim: The study was aimed to evaluate the effectiveness of computer-assisted teaching program (CATP) on malnutrition and its prevention in under-five children among adolescents studying in selected Pre-university College (PUC), Bengaluru.

Methods: A total of 50 students for the academic year 2014–2015 at selected PUC, Bengaluru, were enrolled through simple randomization method in this quasi-experimental study. A structured knowledge questionnaire was developed and had a total of 36 questions related to knowledge and its prevention of malnutrition. 

Results: After administration of teaching program, 92% of subjects had adequate knowledge and 8% had moderate knowledge. None of the subjects had inadequate level of knowledge showing effectiveness of teaching program. Post-test overall knowledge score was significantly higher in comparison to pre-test overall knowledge score (32.20 ± 8.77 vs. 8.14 ± 10.99; P = 0.01). Age, gender, nationality, family income, fathers’ occupation, mothers’ education, religion, students’ status, previous knowledge, and source of information were significantly associated with the post-test level of knowledge on malnutrition and its prevention. 

Conclusion: CATP is effective in increasing knowledge of adolescent regarding malnutrition and its prevention in under-five children.

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Research Article

ArticleID :IJNR/2019/05/02/10

Impact of Educational Program Regarding First-aid Knowledge among the Teenagers

Issue No. 02 (Apr-June)

Authors: K. Renuka, S. Kamala

Introduction: The teachers and teenagers spend considerable hours together within the school environment. Schools are common places where they can find a noticeable risk of physical injuries. 

The aim of the study: The aim of the study was to evaluate the impact of an educational program regarding first-aid knowledge among teenagers.

Methods: Quasi-experimental study with one group pre-/post-test research design was used. The multistage random sample used to select the five groups and the participated 50 teenagers. A structured self-administered questionnaire such as, demographic data and assessment of first aid knowledge questionnaire was used for data collection (Pre-test and Posttest). The findings of the study revealed that mean ± SD of teenagers age were 36.78 ± 7.83, 99% of the teenagers attended an educational program about first aid, there were statistical significant differences between total score of teenagers knowledge (P = 0.001) in pre- and post-test. There was a statistically significant difference between the performance level of teenagers (P = 0.001*). 

Conclusion: The study showed that there was an improvement of teenager’s knowledge and practices regarding first aid after the educational program. The study recommended that continuous educational and training programs for teenagers and public as a whole about first aid.

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Research Article

ArticleID :IJNR/2019/05/02/11

Patient-centered communication and shared decision making to reduce HbA1c levels of patients with poorly controlled type 2 diabetes mellitus - results of the cluster-randomized controlled DEBATE trial

Issue No. 02 (Apr-June)

Authors: Anja Wollny, Attila Altiner, Anne Daubmann, Eva Drewelow, Christian Helbig, Susanne Löscher, Michael Pentzek, Sara Santos, Karl Wegscheider, Stefan Wilm and Christin Löffler

Background: Does an intervention designed to foster patient-centered communication and shared decision making among GPs and their patients with poorly controlled type 2 diabetes mellitus reduce the level of HbA1c.

Methods: The DEBATE trial is a cluster-randomized controlled trial conducted in German primary care and including patients with type 2 diabetes mellitus having an HbA1c level of 8.0% (64 mmol/mol) or above at the time of recruitment. Data was measured before intervention (baseline, T0), 6–8 months (T1), 12–14 months (T2), 18–20 months (T3), and 24–26 months (T4) after baseline. Main outcome measure is the level of HbA1c.

Results: In both, the intervention and the control group the decline of the HbA1c level from T0 to T4 was statistically significant (− 0.67% (95% CI: − 0.80,-0.54%; p < 0.0001) and − 0.64% (95% CI: − 0.78, − 0.51%; p < 0.0001), respectively). However, there was no statistically significant difference between both groups.

Conclusions: Although the DEBATE trial was not able to confirm effectiveness of the intervention tested compared to care as usual, the results suggest that patients with poorly controlled type 2 diabetes are able to improve their blood glucose levels. This finding may encourage physicians to stay on task to regularly approach this cohort of patients.

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Others

ArticleID :IJNR/2019/05/02/12

Improving continuity by bringing the cancer patient, general practitioner and oncologist together in a shared video based consultation – protocol for a randomised controlled trial

Issue No. 02 (Apr-June)

Authors: Theis Bitz Trabjerg, Lars Henrik Jensen, Jens Søndergaard, Jeffrey James Sisler and Dorte Gilså Hansen

Background: Strengthening the coordination, continuity and intersectoral cooperation for cancer patients’ duringcancer treatment is being underlined by international guidelines and research. General practitioners have assumed a growing role in the cancer patient disease trajectory because of their roles as coordinators and the consistent health provider. However, general practitioners are challenged in providing support for cancer patients both during treatment and in the survivorship phase. General practitioners reported barriers are lack of timely and relevant communication from the oncologist and limited knowledge to guidelines, as well as lack of trust from patients. Therefore, the current study will examine whether a shared video-based consultation between the cancer patient, general practitioner and oncologist can ease general’ challenges and thereby enhance the patient-centeredness for the cancer patients and their perception of intersectoral cooperation and continuity.

Methods: The study is designed as a pragmatic randomised controlled trial for patients starting chemotherapy at the Department of Oncology, Lillebaelt Hospital, Denmark who are listed with a general practitioner in the Region of Southern Denmark. We intend to include 278 adults diagnosed with colorectal, breast, lung, gynecologic or prostate cancer. The intervention group will receive the “Partnership intervention” which consists of one or more video-consultations between the cancer patient, general practitioner and oncologist. The consultations are estimated to last between 10 and 20min. The specific aims of the consultation are, summary of the patient trajectory, sharing of knowledge regarding comorbidity, psychosocial resources and needs, physical well-being, medicine, anxiety and depression symptoms, spouses, workability and late complication and side-effects to the cancer treatment.

Discussion: Video-based consultation that brings the cancer patient, the general practitioner and the oncologist together in the early phase of treatment may facilitate a sense of partnership that is powerful enough to improve the patient’s perception of intersectoral cooperation, continuity of cancer care and health-related quality of life.

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Research Article

ArticleID :IJNR/2019/05/03/01

A Study to Evaluate the Effectiveness of Structured Educational Package on Knowledge Regarding Oral Hygiene among Primary Schoolchildren Studying in Selected Schools, Karnataka, India

Issue No. 03 (July-Sept)

Authors: Nice Joseph, Bincy Biju, Feba George, Haritha Mohanan, Linu John, Padma Harikantra, Pratiksha Naik, Sheetal Naik

Background: The oral health is a fundamental part of the general health and well-being of an individual. It can be achieved by maintaining a good oral hygiene. Oral hygiene is the individual habit and professional methods used to control the bacterial biofilm (dental plaque) that grows on the tooth surface. If not removed regularly, dental plaque can lead to tooth decay and cause periodontal diseases. 

Aim: This study aims to evaluate the effectiveness of structured educational package on knowledge regarding oral hygiene among students in selected schools, Karnataka. Methods: An evaluative approach with true experimental pretest-posttest design was used for the study. Twenty-eight primary schoolchildren were selected in control group from the practicing primary school and 25 primary schoolchildren were selected in the experimental group from the Nirmala Hridaya English Medium School, Ankola. The data were collected by the structured questionnaire which is designed to assess the knowledge regarding oral hygiene. The structured questionnaire consists of two sections. Section A consists of 6 items related to demographic data and Section B consists of 25 items related to knowledge regarding oral hygiene. A structured educational package was prepared and administered regarding oral hygiene after the administration of pre-test to the experimental group and post-test was conducted after 6 days of administration of structured educational package. The data collected were analyzed using descriptive and inferential statistics. 

Results: The findings revealed that in practicing primary school, the mean knowledge pre-test score was 11.928 and the mean post-test knowledge score was 12.35. In Nirmala Hrudaya English Medium School, the mean knowledge pre-test score was 8.8 and the mean post-test knowledge score was 14.24. 

Conclusion: The study findings revealed that there was a significant increase in knowledge level of primary schoolchildren after administration of the structured educational package.

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Research Article

ArticleID :IJNR/2019/05/03/02

Comparative Study to Assess the Knowledge Regarding Newborn Care between Mother and Father in Selected Hospitals of Pune City

Issue No. 03 (July-Sept)

Authors: Bhagyashree Jogdeo, Jeena Khumujam

Children are the future of society, and mother and father are the guardian of that future. Conventionally, the role of mother as a direct caregiver and the role of a father is providing financial support. However, nowadays, both are involved in direct care as well as financial outlook. This new trend accepted by various countries. Father also availing the facility of leave after delivery of newborn. 

Aim: The aim of the study was to compare the knowledge regarding newborn care between mother and father. 

Objectives: (1) The objectives of the study were to assess the knowledge regarding newborn care among parents and (2) to associate the findings with selected demographic variables. 

Materials and Methods: A total of 200 parents were selected as samples by nonprobability convenient sampling technique used to collect the data. Research tool includes Sections I and II. Section I includes demographic variables of parents. Section II consists of a structured questionnaire to assess the knowledge of parents regarding newborn care. The tool was content validated by experts and translated into the local language which was again validated. The reliability value is 0.78, which is high. The analysis was performed using frequency and percentage distribution and Fisher’s exact test. 

Results: Father and mother have an equal level of knowledge regarding newborn care. A significant association between knowledge and parents age, no of children, and previous knowledge. Mother’s knowledge regarding newborn care significantly associated with her educational status, occupation, source of information, religion, family income. 

Conclusion: Research findings show that mother and father have average knowledge regarding newborn care. These findings indicate the need for awareness among parents to decrease the infant mortality rate due to malpractice.

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Others

ArticleID :IJNR/2019/05/03/03

Effect of Intra Umbilical Vein (IUV) Injection of Oxytocic Agents on Outcome of the Third Stage of Labor: A Meta-analysis

Issue No. 03 (July-Sept)

Authors: Ravin Kumar Bishnoi, Shivani Devi, Shrikant Desai

Background: Active management of the third stage of labor can easily prevent life-threatening complications of the third stage such as retention of the placenta or its parts, prolonged duration, or postpartum hemorrhage due to atonicity of the uterus. Intraumbilical vein (IUV) injection of oxytocic agents is recommended by some guidelines. Unfortunately, intravenous (IV) oxytocin, although common practice, has not been compared with IUV oxytocic agents in reviews and meta-analysis. Therefore, the main objective of this meta-analysis was to compare the effects of IUV oxytocic agents with intramuscular (IM) and Intravenous (IV) oxytocics on outcomes of the third stage. 

Materials and Methods: The authors searched randomized and non-randomized control trials through electronic databases which include PubMed, Cochrane Library, and CINAHL and gray literature. The search terms were “umbilical vein injection,” “intraumbilical vein injection,” “umbilical vein oxytocin,” oxytocin, uterotonic, placenta, “retained placenta,” labor, “third stage of labor,” and “postpartum hemorrhage.” Five hundred and ninety-four articles were identified and nine met the inclusion criteria. Data were analyzed by Review Manager 5.3. 

Results: The pooled results reported that duration of the third stage was 1.23 minutes (95% confidence interval [CI]: 0.41–2.04) shorter, amount of blood loss was 79.09 ml. (95% CI: 46.90–111.28) lesser, and placental separation time was 37.69 seconds (95% CI: 0.58–74.80) shorter in the IUV oxytocin group than the IV oxytocin group. Comparison of IUV oxytocin and IV carbetocin shows no statistically significant differences. In comparison with IM oxytocin, IUV oxytocin also results in 1.13 min (95% CI: 0.28–1.97) shorter duration of the third stage of labor but not shows any significant difference for amount of blood loss. 

Conclusion: IUV oxytocin is more beneficial for reduction of duration of the third stage of labor, amount of blood loss, and placental separation time than the IV and IM oxytocin.

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Research Article

ArticleID :IJNR/2019/05/03/04

Effectiveness of Foot Massage and Mitchell’s Relaxation Technique on Physiological and Psychological Parameters of Patients Undergoing Elective Angioplasty

Issue No. 03 (July-Sept)

Authors: Shilpa, C. V. Sheeja, T. M. Assuma Beevi

Aim: The aim of the study is to evaluate the effectiveness of foot massage and Mitchell’s relaxation technique on physiological and psychological outcome of patients undergoing elective angioplasty. 

Background: The physiological parameters of patients will be altered due to stress. Use of alternative therapies is needed to improve health and considered as therapeutic perquisites. Foot massage and Mitchell’s relaxation technique would reduce stress, blood pressure (BP), heart rate (HR), and respiratory rate and have certain health benefits. 

Methods: Quasi-experimental study with two group pre-test and post-test design was adopted with purposive sampling on 30 study participants who have fulfilled the inclusion criteria and randomly allotted into two groups. Group 1 for foot massage and Group 2 for Mitchell’s relaxation technique for 3 days at morning 7 AM and evening 7 PM. Socio-demographic and clinical profile datasheet and stress rating scale were used to collect the data. After giving six interventions, on 3rd -day post-test was done. 

Results: Both Mitchell’s relaxation technique and foot massage were effective in lowering physiological and psychological parameters. HR, BP, and stress level of patients who had massage and BP and stress level for those had Mitchell’s relaxation were statistically significant at 0.05 levels (P < 0.05). Age of the patient was significantly associated with HR. Exercise and personal habits had a significant association with pre-test stress score at 0.05 levels (P < 0.05).

Conclusion: Foot massage is found to be more effective in reducing BP, HR, and stress level than Mitchell’s relaxation technique in patients undergoing elective angioplasty. As a regular nursing intervention, these therapies can be incorporated.

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Research Article

ArticleID :IJNR/2019/05/03/05

Impact of an Educational Intervention on Care Burden among the Caregivers of Patients Undergoing Hemodialysis

Issue No. 03 (July-Sept)

Authors: Brincy Darwin John, Susan Jacob

Background: Chronic kidney disease (CKD) is a major disease burden, which is affecting the population across the globe, CKD patients depends on hemodialysis to sustain life. These patients are cared by an informal support system comprises spouse, father, mother, daughter, son, or any other caregiver who are related or not related to patient. Providing continuous care for such type of patients whose prognosis, an irreversible outcome is an overwhelming experience for caregivers due to physical and psychological distress, limitations to their personal and social activities, and impending financial burden.

Objective: The objective of this study was to assess the burden among the caregivers of patients undergoing hemodialysis before and after the educational intervention. 

Methods: A quasi-experimental one-group pre- and post-test design was used. Sixty participants were selected through non-probability convenient sampling. Care burden was assessed through standardized tool (Zarit Care Burden Interview) with r-value of 0.98. 

Results: Statistical analysis shows that the pre-test mean score was 45.63 with standard deviation (SD) of 10.42, whereas post-test mean score was 27.13 with SD of 8.69. Wilcoxon signed-rank test; a non-parametric test was applied, and P-value was found to be < 0.001 at 95% of the confidence interval (P < 0.05). Therefore, the educational intervention on home care management was found to be effective in reducing the care burden among the caregivers of hemodialysis patients. 

Conclusion: Hence, educational intervention on home care management was an effective reinforcement strategy to reduce the care burden among the care providers of hemodialysis patients.

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Research Article

ArticleID :IJNR/2019/05/03/06

A global picture of family medicine: the view from a WONCA Storybooth

Issue No. 03 (July-Sept)

Authors: Vincent K. Cubaka, Clayton Dyck, Russell Dawe, Baraa Alghalyini, Molly Whalen-Browne, Gabriel Cejas and Christine Gibson

Background: Family Medicine is a novel discipline in many countries, where the motivation for training and value added to communities is not well-described. Our purpose was to understand the reason behind the choice of Family Medicine as a profession, the impact of Family Medicine on communities, and Family Medicine’s characterizing qualities, as perceived by family doctors around the world.

Methods: One-question video interviews were conducted using an appreciative inquiry approach, with volunteer participants at the 2016 World Organization of Family Doctors conference in Rio de Janeiro. Qualitative data analysis applied the thematic, framework method.

Results: 135 family doctors from 55 countries participated in this study. Three overarching themes emerged: 1) key attributes of Family Medicine, 2) core Family Medicine values and 3) shared traits of family doctors. Family Medicine attributes and values were the key expressed motivators to join Family Medicine as a profession and were also among expressed factors that contributed to the impact of Family Medicine globally. Major sub-themes included the principles of comprehensive care, holistic care, continuity of care, patient centeredness, and the patient-provider relationship. Participants emphasized the importance of universal care, human rights, social justice and health equity.

Conclusion: Family doctors around the world shared stories about their profession, presenting a heterogeneous picture of global Family Medicine unified by its attributes and values. These stories may inspire and serve as positive examples for Family Medicine programs, prospective students, advocates and other stakeholders.

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Research Article

ArticleID :IJNR/2019/05/03/07

Diagnostic methods for acute otitis media in 1 to 12 year old children: a cross sectional study in primary health care

Issue No. 03 (July-Sept)

Authors: Pär-Daniel Sundvall, Chrysoula E. Papachristodoulou and Lena Nordeman

Background: Otoscopy alone has low sensitivity and specificity for acute otitis media (AOM). Otomicroscopy and pneumatic methods are superior to otoscopy. However, these methods require clinical skills. The use of different diagnostic methods for AOM differs between countries and has not been evaluated in Sweden since new guidelines were introduced in 2010. This study aimed to describe the extent of which diagnostic methods and written advice were used for AOM in children 1 to 12 years old.

Methods: In this cross-sectional study all general practitioners (GPs) and specialist trainees in primary care (STs) at 27 primary health care centres in Sweden were asked to complete a self-administrated questionnaire including diagnostic approach and the management of AOM; 75% (111/148) responded to the questionnaire. 

Outcome Measures: GPs versus STs and their gender, the use of otoscopy, pneumatic otoscopy, otomicroscopy, tympanometry and written advice. Logistic regressions were used to evaluate the association between GPs versus STs and their gender and the use of diagnostic methods and written advice.

Results: To diagnose AOM, 98% of the GPs and STs often or always used otoscopy, in addition to this 17% often or always used otomicroscopy, 18% pneumatic otoscopy and 11% tympanometry. Written advice to parents was provided often or always by 19% of the GPs and STs. The GPs used otomicroscopy more often than STs, adjusted OR 4.9 (95% CI 1.5–17; p = 0.011). For the other diagnostic methods, no differences were found. Female GPs and STs provided written advice more often than male GPs and STs, OR 5.2 (95% CI, 1.6–17; p = 0.0061), adjusted for GP versus ST.

Conclusions: Otoscopy was by far the most commonly used method for the diagnosis of AOM. Female GPs and STs provided written advice more frequently than did their male colleagues. GPs used the significantly better method otomicroscopy more often than STs, therefore, it is important to emphasise teaching of practical skills in otomicroscopy in the specialist training programme for general practice. A correct diagnosis is important for avoiding potentially harmful antibiotic treatments, antimicrobial resistance and possible delay of other diagnoses.

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Research Article

ArticleID :IJNR/2019/05/03/08

Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study

Issue No. 03 (July-Sept)

Authors: Cesar I. Fernandez-Lazaro, Juan M. García-González, David P. Adams, Diego Fernandez-Lazaro, Juan Mielgo-Ayuso, Alberto Caballero-Garcia, Francisca Moreno Racionero, Alfredo Córdova

Background: Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings.

Methods: A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors.

Results: The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10- year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence.

Conclusions: Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

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Research Article

ArticleID :IJNR/2019/05/03/09

An educational study to investigate the efficacy of three training methods for infiltration techniques on self-efficacy and skills of trainees in general practice

Issue No. 03 (July-Sept)

Authors: Nele R. Michels and Els Vanhomwegen

Background: Research shows that few general practitioners perform intra- and periarticular infiltrations. Lack of good training strategies to teach these skills would be an important reason for this observation. In this study, we investigated and compared three different training strategies for infiltrations of the glenohumeral joint, subacromial space, lateral epicondyle, carpal tunnel and knee joint.

Methods: Trainees in general practice were randomized into three teaching groups: a theoretical lecture (n = 18), or a theoretical lecture with training on anatomical models (n = 19) or with a training on cadavers (n = 11). The study period was 3 months. Before and after the training, the self-efficacy (questionnaire) and skills (Objective Structured Clinical Examination or OSCE, test on anatomical models) were evaluated. The self-efficacy was assessed again 3 months later. A Kruskal-Wallis test was used to compare the results before versus after training and between groups (p < 0.05).

Results: All three training strategies had a significantly positive effect on the self-efficacy concerning knowledge and skills. This benefit remained 3 months after training. However, some participants still felt uncomfortable to perform infiltrations. Best scores for self-efficacy concerning skills and best scores on the OSCE were observed after training on cadavers, followed by training on anatomical models.

Conclusions: Based on this study we suggest the combination of a theoretical lecture with a training on cadavers to teach infiltration techniques. To achieve an optimal long-term effect, additional refresher trainings may be necessary.

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Research Article

ArticleID :IJNR/2019/05/04/01

A Comparative Study of Open Cholecystectomy versus Laparoscopic Cholecystectomy in a Selected Hospital in Guwahati, Assam

Issue No. 04 (Oct-Dec)

Authors: Nazima Begum, Roonmoni Deka, Partha Pratim Das

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. However, with the advent of laparoscopic cholecystectomy (LC), there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser post-operative pain LC is also cosmetically better. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice. Aim: This study aims to compare OC with LC in selected hospitals in Guwahati, Assam. 

Objectives: The objective of the study was to evaluate the outcomes of with OC in relation to safety, efficacy, complications, cost, and satisfaction. 

Materials and Methods: It is a prospective randomized study of patients (500 each from LC and OC) having cholecystectomy aged between 13 and 81 years. Structured questionnaire was prepared for data collection. “Statistical analysis done in Excel Window 2010.” 

Results: The mean operation time for LC is 59.32 min and 69.22 min for OC (P < 0.001). The use of injectable analgesics in case of LC (mean number of days = 3.37) is considerably less than OC (mean number of days = 6.19). The conversion rate is 4.8%. Complication rate is higher in OC (17.9%) and in LC, it is 8.19%. Post-operative infection is 3.3% in LC and 7.5% in OC. 

Conclusion: LC is found to be better than OC in terms of post-operative pain, analgesic requirement, and early return to work.

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Research Article

ArticleID :IJNR/2019/05/04/02

Involving Clients to Inform Development and Implementation of Combined Type 2 Diabetes and Chronic Kidney Disease Care Using Discovery Interview Technique

Issue No. 04 (Oct-Dec)

Authors: Denise Blanchfield, Laserina O’Connor

Introduction: The development of chronic kidney disease in persons with Type 2 diabetes has been described as an epidemic. Standard outpatient care for these associated conditions is routinely provided separately, resulting in missed opportunities to implement preventative and early management strategies. Historically, care delivery for these combined conditions has fallen within the remit of medical professionals, evidenced by a dearth of information pertaining to the contribution of advanced practice nursing for this cohort. Clients report an uncoordinated impersonal approach to care delivery for associated conditions, however incorporating their experience is vital to the delivery of patient centered care and will be included in this study through their stories. The primary aim of this participatory action research (PAR) study is to utilize the client care stories and healthcare professional perspectives to inform development and implementation of a new combined Type 2 diabetes and chronic kidney disease service in the context of advanced practice nursing. 

Methodology: This study adopted a PAR approach informed by patient discovery interviews and key stakeholders focus groups. Transcripts will be developed from discovery interviews and focus groups and analyzed using thematic analysis. 

Results: The PAR will utilize thematic analysis outcomes to inform the primary aim and clinical outcomes from combined care will be evaluated after 9 months by retrospective chart review. 

Conclusion: The approach adopted in this study represents a departure from traditional medically led care strategies. Outcomes may elucidate potential challenges to the development and delivery of innovative care delivery for underserved patient cohorts in the context of advanced practice nursing.

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Research Article

ArticleID :IJNR/2019/05/04/03

To Assess the Quality of Life among Primary Caregivers of Intellectually Disabled Children Attending Outpatient Department in a Tertiary Health Center of City

Issue No. 04 (Oct-Dec)

Authors: Sumit Khare, Shilpa Parkhe, Pratibha Gunjal, Sonali Shinde, Rama Arbatti

Introduction: Acceptance of child with intellectual disability (ID), once called mental retardation, becomes difficult to parents and the whole family, particularly when competence and achievement are very much valued in modern world. A parent shows a series of reaction including shock, denial, guilt, sorrow, rejection, and acceptance after knowing that their child is disabled. It is also important to note that caring for a child with disability does not equally affect all parents. There are families who cope well despite the adversity. There could be a number of factors that can affect the quality of life (QOL) of carers which could include severity of the disability of the child, presence of cognitive or behavioral problems, socioeconomic status of the families, lack of education, low social support, etc. The research investigated differences of overall QOL between QOL for caregivers of children with autism spectrum disorder and an ID was compared to QOL for those caring for a normally developing child. 

Materials and Methods: The study was conducted in Maharashtra Institute of Mental Health, Sassoon General Hospital, Pune. Target population was primary caregivers of intellectually disabled children. The samples were selected by convenience sampling technique, a total of 100 samples were selected. 

Results: Data analysis was done by descriptive and inferential statistics. Chi-square test was applied to find out the association between the study findings with selected demographic variables. The Chi-square value for the type of family was 24.6 with 0.05% level of significance, which is greater than tabulated value; hence, there was a significant association between the type of family and QOL of primary caregivers. This was also evident that the overall QOL of primary caregivers comes under satisfactory category. 

Conclusion: The study concludes that the QOL of primary caregivers is related to the type of disability, duration of disability, and the social support available for the caregivers. More the duration, more the social support, and lesser disability lead to better QOL of primary caregivers of intellectually disabled children.

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Research Article

ArticleID :IJNR/2019/05/04/04

Acceptability of the BATHE technique amongst GPs and frequently attending patients in primary care: a nested qualitative study

Issue No. 04 (Oct-Dec)

Authors: Clare Thomas, Helen Cramer, Sue Jackson, David Kessler, Chris Metcalfe, Charlie Record and Rebecca K. Barnes

Background: BATHE is a brief psychosocial intervention designed for physician use in patient consultations. The technique has gained some international recognition, but there is currently limited research evidence to demonstrate its acceptability and benefits to patient care. We conducted a pilot cluster randomised controlled trial and feasibility study to explore the use of BATHE as a key component of a person-focused intervention to improve the care of frequent attending patients in UK primary care.

Methods: A nested qualitative interview study conducted within a pilot trial. The trial took place in six general practices in the South West of England. Eligible patients had been identified as being in the top 3% of attenders in the previous 12 months. General practitioners (GPs) were trained to use BATHE during a one-hour initial training session, and two top-up trainings which included feedback on implementation fidelity. GPs were asked to use BATHE with their study patients for a period of 12 months. 34 GPs were trained and documented using BATHE in a total of 577 consultations with eligible patients during the intervention period. At the end of the intervention period, GPs and study patients from the intervention practices were invited to take part in an interview. Interviews were semi-structured, audio-recorded and transcribed. Thematic analysis was used.

Results: Eleven GPs and 16 patients took part in post-intervention interviews. Benefits of using BATHE included making consultations more person-centred, challenging assumptions that the GP knew what was going on for the patient and their main concerns, and supporting self-management. Difficulties reported included changing existing consultation habits, identifying appropriate consultations in which to use BATHE, and organizational constraints.

Conclusions: The study suggests that using BATHE is both acceptable and beneficial but also highlighted some of the difficulties GPs had incorporating BATHE into routine practice. Strategies to reduce these difficulties are needed before the extent of the potential benefits of BATHE can be fully assessed.

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Research Article

ArticleID :IJNR/2019/05/04/05

Health TAPESTRY: co-designing interprofessional primary care programs for older adults using the persona-scenario method

Issue No. 04 (Oct-Dec)

Authors: Ruta Valaitis, Jennifer Longaphy, Jenny Ploeg, Gina Agarwal, Doug Oliver, Kalpana Nair, Monika Kastner, Ernie Avilla and Lisa Dolovich

Background: Working with patients and health care providers to co-design health interventions is gaining global prominence. While co-design of interventions is important for all patients, it is particularly important for older adults who often experience multiple and complex chronic conditions. Persona-scenarios have been used by designers of technology applications. The purpose of this paper is to explore how a modified approach to the persona-scenario method was used to co-design a complex primary health care intervention (Health TAPESTRY) by and for older adults and providers and the value added of this approach.

Methods: The persona-scenario method involved patient and clinician participants from two academically-linked primary care practices. Local prospective volunteers and community service providers (e.g., home care services, support services) were also recruited. Persona-scenario workshops were facilitated by researchers experienced in qualitative methods. Working mostly in homogenous pairs, participants created a fictitious but authentic persona that represented people like themselves. Core components of the Health TAPESTRY intervention were described. Then, participants created a story (scenario) involving their persona and an aspect of the proposed Health TAPESTRY program (e.g., volunteer roles). Two stages of analysis involved descriptive identification of themes, followed by an interpretive phase to extract possible actions and products related to ideas in each theme.

Results: Fourteen persona-scenario workshops were held involving patients (n = 15), healthcare providers/community care providers (n = 29), community service providers (n = 12), and volunteers (n = 14). Fifty themes emerged under four Health TAPESTRY components and a fifth category - patient. Eight cross cutting themes highlighted areas integral to the intervention. In total, 414 actions were identified and 406 products were extracted under the themes, of which 44.8% of the products (n = 182) were novel. The remaining 224 had been considered by the research team. 

Conclusions: The persona-scenario method drew out feasible novel ideas from stakeholders, which expanded on the research team’s original ideas and highlighted interactions among components and stakeholder groups. Many ideas were integrated into the Health TAPESTRY program’s design and implementation. Persona-scenario method added significant value worthy of the added time it required. This method presents a promising alternative to active engagement of multiple stakeholders in the co-design of complex interventions.

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Research Article

ArticleID :IJNR/2019/05/04/06

Impact of rural address and distance from clinic on depression outcomes within a primary care medical home practice

Issue No. 04 (Oct-Dec)

Authors: Hailon Wong, Kyle Moore, Kurt B. Angstman and Gregory M. Garrison

Background: Depression is the second leading cause of death among young adults and a major cause of disabilityworldwide. Some studies suggest a disparity between rural and urban outcomes for depression. Collaborative Care Management (CCM) is effective in improving recovery from depression, but its effect within rural and urban

populations has not been studied.

Methods: A retrospective cohort study of 3870 patients diagnosed with depression in a multi-site primary care practice that provided optional, free CCM was conducted. US Census data classified patients as living in an Urban Area, Urban Cluster, or Rural area and the distance they resided from their primary care clinic was calculated. Baseline demographics, clinical data, and standardized psychiatric assessments were collected. Six month Patient Health Questionnaire (PHQ 9) scores were used to judge remission (PHQ9 < 5) or Persistent Depressive Symptoms (PDS) (PHQ9 ≥ 10) in a multivariate model with interaction terms.

Results: Rural patients had improved adjusted odds of remission (AOR = 2.8) and PDS (AOR = 0.36) compared to urban area patients. The natural logarithm transformed distance to primary care clinic was significant for rural patients resulting in a lower odds of remission and increased odds of PDS with increasing distance from clinic. The marginal probability of remission or PDS for rural patients equaled that of urban area patients at a distance of 34 or 40 km respectively. Distance did not have an effect for urban cluster or urban area patients nor did distance interact

with CCM.

Conclusion: Residing in a rural area had a beneficial effect on the recovery from depression. However this effect declined with increasing distance from the primary care clinic perhaps related to greater social isolation or difficulty accessing care. This distance effect was not seen for urban area or urban cluster patients. CCM was universally beneficial and did not interact with distance.

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Research Article

ArticleID :IJNR/2019/05/04/07

Weight loss in conservative treatment of obesity in women is associated with physical activity and circadian phenotype: a longitudinal observational study

Issue No. 04 (Oct-Dec)

Authors: Eva Fárková, Jakub Schneider, Michal Šmotek, Eduard Bakštein, Jitka Herlesová, Jana Kopřivová, Petra Šrámková, Dita Pichlerová and Martin Fried

Introduction: The study investigates the association between circadian phenotype (CP), its stability (interdaily stability - IS) and physical activity (PA) in a weight loss (WL) programme.

Methods: Seventy-five women in WL conservative treatment (BMI ≥ 25 kg/m2) were measured (for about 3 months in between 2016 and 2018) by actigraphy.

Results: We observed a difference in time of acrophase (p = 0.049), but no difference in IS (p = 0.533) between women who lost and did not lose weight. There was a difference in PA (mesor) between groups of women who lost weight compared to those who gained weight (p = 0.007). There was a relationship between IS and PA parametres mesor: p0.001; and the most active 10 h of a day (M10): p < 0.001 - the more stable were women in their rhythm, the more PA they have. Besides confirming a relationship between PA and WL, we also found a relation between WL and CP based on acrophase. Although no direct relationship was found for the indicators of rhythm stability (IS), they can be considered very important variables because of their close connection to PA – a main factor that contributes to the success of the WL programme.

Discussion: According to the results of the study, screening of the CP and its stability may be beneficial in the creation of an individualized WL plan.

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Research Article

ArticleID :IJNR/2019/05/04/08

Use of interval-censored survival data as an alternative to Kaplan-Meier survival curves: studies of oral lesion occurrence in liver transplants and cancer recurrence

Issue No. 04 (Oct-Dec)

Authors: Agatha S. Rodrigues, Vinicius F. Calsavara, Felipe I. B. Silva, Fábio A. Alves and Ana P. M. Vivas

After undergoing liver transplantation, children are susceptible to oral lesions due to immunosuppressant drugs thatare needed to maintain the transplant. In this context, it is important to understand how disease characteristics and age at transplantation influence the development of these lesions. Monitoring of lesions begins after transplantation and children are usually observed by a specialist in stomatology at periodic visits. Consequently, lesion development is estimated to occur between two observed times, and this is characterized as interval-censored data. However, in clinical practice, it is common to assume the moment of observation as the time of event occurrence, thereby excluding interval-censored data. Here, we discuss the impact of excluding interval-censored mechanisms in statistical analyses by using simulation studies to consider differences in sample sizes and amplitudes between observed intervals. Then, application studies are presented which use a data set from a prospective study that was conducted to investigate oral lesions in patients after liver transplantation at the A.C.Camargo Cancer Center in Brazil between 2013 and 2016 and a data set involving recurrent ovarian cancer in patients diagnosed with high-gradeserous carcinoma at the A.C.Camargo Cancer Center between 2003 and 2016.

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Research Article

ArticleID :IJNR/2020/06/01/01

A Study to Assess the Effectiveness of Foot Reflexology for Prevention of Breast Engorgement among Lower Segment Cesarean Section Mothers in a Selected Hospital of a Metropolitan City

Issue No. 01 (Jan-Mar)

Authors: Nilofar Loladiya, Jacintha Lobo

Background: Puerperium is the period beginning immediately after the birth of the child and it is an important moment in the life of a woman. Breast engorgement is very common and has an effect on self and newborn care. Breast engorgement is distention or vascular congestion in the process of swelling of the breast tissue brought about by an increase in blood and lymph supply to the breast as the body produces milk, which precedes true lactation. Reflexology has huge health benefits and it alleviates women’s pregnancy and nursing experiences too. Reflexology increases the health and well-being of women and provides a comforting and nurturing environment for both mother and baby. Lower segment cesarean section (LSCS) being an operative procedure restricts the movement of mother which hinders self and newborn care. Reflexology aims to engage body’s own healing process, treating the person as a whole, i.e. the mind, body, and soul. 

Aim: This study aims to assess the effectiveness of foot reflexology for the prevention of breast engorgement among LSCS. 

Materials and Methods: A quasi experimental design was used for this study. The study was performed on 80 postnatal mothers of postnatal ward of a selected hospital of a metropolitan city. 

Results: The study results show that there was a reduction in breast engorgement among LSCS mothers after the application of foot reflexology which was statistically verified. 

Conclusion: The analysis of data showed that foot reflexology can be used for the prevention of breast engorgement among LSCS mothers.

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Research Article

ArticleID :IJNR/2020/06/01/02

Assess the Knowledge and Practice on Nesting of New Born among Postnatal Mothers with a View to Prepare Information Booklet

Issue No. 01 (Jan-Mar)

Authors: Arunima Sreeletha, Dipali Rajendra Salunke, Maheshwari Eknath Sasane, Prajkta Dattatray Waingankar, Rushabh Kishor Kamble, Sandhya Suresh Ghadge, Santosh Ramsubhavan Rajak

Background: Maintaining thermoregulation is very vital for newborn babies in the immediate newborn period and continues until the first half of infancy. Different thermoregulation techniques should be followed traditionally by mothers for the same. 

Objectives: The objectives of the study were to assess knowledge and practice on nesting among postnatal mothers, find out the association between selected demographic variables and knowledge. 

Materials and Methods: This study was a descriptive survey method. The study was conducted at selected hospital in Navi Mumbai in 120 postnatal mothers. Non-probability purposive sampling was used. Tools include sociodemographic and clinical data, knowledge questionnaire, and observational checklist. The tool reliability score is 0.9. 

Results: Frequency distribution of demographic data was calculated. Demographic data reveal that there is an association between age, education, and number of postnatal days with knowledge regarding nesting. Knowledge level regarding nesting among postnatal mothers represents that only one mother has excellent knowledge, 11 have good knowledge, 80 have adequate, and 28 have poor knowledge regarding nesting. Practice on nesting among postnatal mothers represents that 11 mothers have good practice on nesting, 99 are average, and 10 are having poor practice regarding nesting. From finding the researchers found out that knowledge and practice regarding nesting of newborn among postnatal mothers are average. 

Conclusion: As hypothermia is the leading cause of death in neonates, thermoregulatory measures have been recommended by heath-care members. Hence, the present study was conducted to assess knowledge and practice on nesting of newborn among the postnatal mothers toprevent hypothermia.

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Research Article

ArticleID :IJNR/2020/06/01/03

Effectiveness of Educational Intervention on Knowledge Regarding Newborn Care among Nurses Working in Maternity Units of B. P. Koirala Institute of Health Sciences, Nepal

Issue No. 01 (Jan-Mar)

Authors: Gayatri Rai, Mangala Shrestha, Nirmala Pokharel, Sunita Bhandari

Introduction: Globally, 2.5 million children died in the 1st month of life in 2017. An estimated 23,000 children die in Nepal each year before reaching their fifth birthday with three out of five babies dying within 28 days after birth. Children who die within the first 28 days of birth suffer from conditions and diseases associated with lack of quality care at birth or skilled care and treatment immediately after birth and in the 1st day of life. 

Objective: The objective of the study was to assess the effectiveness of educational intervention about newborn care among nurses.

Materials and Methods: A pre-experimental one-group pretest-posttest design was employed in the study. Forty four nurses working in maternity units of B. P. Koirala Institute of Health Sciences were selected through convenient sampling method. A pre-tested structured self-administered questionnaire was used to collect the data. Frequency, percentage, mean, standard deviation, Chi-squared test, and Spearmen correlation were used to analyze the data.

Results: The findings showed that most of the knowledge lacking areas in pretest were cord care, temperature of birth room, first sponge bath, and second follow-up visit for newborn care. The mean±SD knowledge scores were 21.93±7.20 and 33.68±4.31 in pre-test and post-test, respectively. The pre-test and post-test knowledge scores were positively correlated (rs=0.136). 

Conclusion: The findings indicated that educational intervention was effective for enhancing nurses’ knowledge of newborn care. Continue nursing education and training for nurses would be beneficial to increase nurses’ knowledge on newborn care.

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Research Article

ArticleID :IJNR/2020/06/01/04

A Pre-experimental Study to Assess the Effectiveness of Self-Structured Teaching Plan of Knowledge on Menstrual Hygiene among Nursing Students of Himalayan School of Nursing, Ambala (Haryana)

Issue No. 01 (Jan-Mar)

Authors: Renu Bala, Madhu B. Bala, Madhu C. Bala, Santosh, Sangeeta Kaushal, Shabnam Kumari

Aim: The present study aims to assess and compare the knowledge on menstrual hygiene among nursing students of Himalayan School of Nursing, Ambala (Haryana), before and after implementation of self-structured teaching plan.

Materials and Methods: A quantitative study using pre-experimental pre-test and post-test design. A sample size of 60 nursing students was selected using random sampling technique, semi-structured questionnaire was used to process the level of knowledge of nursing students on menstrual hygiene. 

Result: The finding of the study had showed that in pre-test knowledge score, majority of the nursing students had excellent level of knowledge, i.e., 5% followed by 30% had good level of knowledge, 65% had very good level of knowledge, and 0% had poor level of knowledge. In post-test knowledge score, majority of nursing students had good level of knowledge, i.e., 21.6% followed by 66.6% had very good level of knowledge, 11.6% had excellent, and 0% poor level of knowledge. It was concluded that there is increased in post-test knowledge score as compared to pre-test knowledge score. It was found that all the sociodemographic variables such as age, religion, occupation, residence, and source of information on menstrual hygiene are non-statistically significant.

conclusion: The finding of the study reveals that the mean of pre-test level of knowledge score is 11.38 and the mean of post-test level of knowledge score is 12.16.

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Research Article

ArticleID :IJNR/2020/06/01/05

A Description of the Knowledge and Attitude Toward Premarital Sickle Cell among Unmarried Adults Residence of Naraguta Village in Jos North

Issue No. 01 (Jan-Mar)

Authors: Mafuyai Joseph Mangai, Hosea Gotodok, Bonji Gaknung, Ari Eunice

Introduction: Premarital sickle cell screening is a test done to screen intending couples to determine their genotype before marriage. It provides information about the health of the individuals while assessing their related reproductive risk.

Aim: This study aimed to assess the knowledge of adults on premarital sickle cell screening among unmarried residence of Naraguta village in Jos North, Plateau state. 

Methodology: A descriptive research design was adopted, sample size of 306 adult residences was drawn from an estimated of 1500 through a proportional stratified sampling technique. Structured questionnaire was used to obtained the data and was analyzed through descriptive and inferential statistics.

Results: Findings or result revealed that most of the adult respondents (71%) had low knowledge about premarital sickle cell screening and (53%) and had negative attitude toward premarital sickle cell screening. Of the respondents (31%) of the adult unmarried are not intending to comply to the screening and stated their reasons to be that the screening is costly and is waste of time and resources. Furthermore, there was a significant relationship between knowledge and attitude toward premarital sickle cell screening among the unmarried adult residence of Naraguta village. This indicates that knowledge about premarital sickle cell screening has a great impact in developing positive attitude toward sickle cell screening. 

Conclusion: It was, therefore, concluded that the unmarried adult at the Naraguta village has low level and knowledge and negative attitude toward premarital sickle cell screening.

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Research Article

ArticleID :IJNR/2020/06/01/06

A Descriptive Study to Assess the Knowledge and Practices Regarding Biomedical Waste Management among the Health Personnel Working at Community Health Centers in a Tribal District

Issue No. 01 (Jan-Mar)

Authors: Nilima Sonawane, Kamble Raosaheb

Aim: The aim of this descriptive study was to assess out the knowledge and practices of the health personnel regarding biomedical waste management (BMWM) working at Community Health Centers in the tribal district of Maharashtra state.

Research Methodology: A descriptive cross-sectional community-based study was conducted in PHC, rural hospital, and subdistrict hospital in the tribal district in the state of Maharashtra. A total of 100 health personnel working in the government setup selected as a sample by simple random sampling. The data were collected using semi-structured questionnaire and self reported observational checklist. The data were analyzed by applying descriptive and inferential statistics. 

Results: Among the 100 health personnel, majority (74%) were female and 26% were male health personnel. As far as their designation was concerned, majority (62%) were staff nurses, 18% were technicians, 15% were pharmacists, and few (5%) health personnel were multipurpose health workers (MPHWs). Work experience, 14% health personnel were having experience <2 years, 3–5 years (24%), 5–10 years (20%), and 42% were having work experience, more than 10 years. According to their age, 38% health personnel were in the age group of 20–30 years, 31–40 years (31%), 41–50 years (26%), and 5% were in the age group of 51–60 years. As far as their training on BMWM was concerned, majority (82%) undergone on the job formal training. The study findings indicated that 86% health personnel having good knowledge regarding BMWM and 14% reported average knowledge. As far as their BMWM practices are concerned, majority (94%) having good practice and 5% were having average practice. There was a significant association of knowledge with qualification and their designation as P ≤ 0.05 at 0.05 level of statistical significance. 

Conclusion: From this study, it can be said that health personnel are aware of the BMWM and this is associated with the training programs attended and designation of them.

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Research Article

ArticleID :IJNR/2020/06/01/07

The Relationship between Health-Related Quality of Life and Burden among Family Caregivers of Elderly Patients Undergoing Hemodialysis in Saudi Arabia

Issue No. 01 (Jan-Mar)

Authors: Faiza A. Abou El-Soud, Manar Nasser Alotaibi, Enas Majed Bin Suhaim, Nwader Aziz Alotaibi

Aim: The aim of the study was to examine the relationship between health-related quality of life (HRQOL) and burden among family caregivers of elderly patients undergoing hemodialysis, in Saudi Arabia. 

Methods: Cross-sectional, descriptive, and correlational designs were used. A structured interviewing questionnaire was used to recruit 50 caregivers randomly. Pearson correlation was used to correlate between socio-demographic data, HRQOL, and burden degree. Ethical approval was assured. 

Results: A statistically significant negative association between the degree of burden and HRQOL among family caregivers was found. There was a significant positive association between burden degree and the caregivers’ age, marital status, the duration of caregiving and care of recipient’s age, physical function, physical health problems, and emotional problems. Meanwhile, there was a negative association between burden degree and level of education, general health perception, emotional well-being, vitality, and social functioning. 

Conclusion: When the nurses understand the relationship between burden of care experience among the caregivers and HRQOL that lead them to intervene effectively with a multi-disciplinary team to support caregivers for minimizing the level of burden and avoid burnout.

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Research Article

ArticleID :IJNR/2020/06/01/08

Regret among primary care physicians: a survey of diagnostic decisions

Issue No. 01 (Jan-Mar)

Authors: Beate S. Müller, Norbert Donner-Banzhoff, Martin Beyer, Jörg Haasenritter, Angelina Müller and Carola Seifart

Background: Experienced and anticipated regret influence physicians’ decision-making. In medicine, diagnostic decisions and diagnostic errors can have a severe impact on both patients and physicians. Little empirical research exists on regret experienced by physicians when they make diagnostic decisions in primary care that later prove inappropriate or incorrect. The aim of this study was to explore the experience of regret following diagnostic decisions in primary care.

Methods: In this qualitative study, we used an online questionnaire on a sample of German primary care physicians. We asked participants to report on cases in which the final diagnosis differed from their original opinion, and in which treatment was at the very least delayed, possibly resulting in harm to the patient. We asked about original and final diagnoses, illness trajectories, and the reactions of other physicians, patients and relatives. We used thematic analysis to assess the data, supported by MAXQDA 11 and Microsoft Excel 2016.

Results: 29 GPs described one case each (14 female/15 male patients, aged 1.5–80 years, response rate < 1%). In 26 of 29 cases, the final diagnosis was more serious than the original diagnosis. In two cases, the diagnoses were equally serious, and in one case less serious. Clinical trajectories and the reactions of patients and relatives differed widely. Although only one third of cases involved preventable harm to patients, the vast majority (27 of 29) of physicians expressed deep feelings of regret.

Conclusion: Even if harm to patients is unavoidable, regret following diagnostic decisions can be devastating for clinicians, making them ‘second victims’. Procedures and tools are needed to analyse cases involving undesirable diagnostic events, so that ‘true’ diagnostic errors, in which harm could have been prevented, can be distinguished from others. Further studies should also explore how physicians can be supported in dealing with such events in order to prevent them from practicing defensive medicine.

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Research Article

ArticleID :IJNR/2020/06/01/09

Tinkering at the margins: evaluating the pace and direction of primary care reform in Ontario, Canada

Issue No. 01 (Jan-Mar)

Authors: Monica Aggarwal and A. Paul Williams

Background: Primary care reform has been on the political agenda in Canada and many industrialized countries for several decades; it is widely seen as the foundation for broader health system transformation. Federal investments in primary care, including major cash transfers to provinces and territories as part of a 10-year health care funding agreement in 2004, triggered waves of primary care reform across Canada. Nevertheless, Commonwealth Fund surveys show, Canada continues to lag behind other industrialized nations with respect to timely access to care, electronic medical record use and audit and feedback for quality improvement in primary care. This paper evaluates the pace and direction of primary care reform as well as the extent of resulting change in the organization and delivery of primary care in Ontario, Canada’s most populous province.

Methods: Qualitative and quantitative methods were used for this study. A literature review was conducted to analyze the core dimensions of primary care reform, the history of reform in Ontario, and the extent to which different dimensions are integrated into Ontario’s models. Quantitative data on the number of family physicians/general practitioners and patients enrolled in these models was examined over a 10-year period to determine the degree of change that has taken place in the organization and delivery of primary care in Ontario.

Results: There are 11 core reform dimensions that individually and collectively shift from conventional primary care toward the more expansive vision of primary health care. Assessment of Ontario’s models against these core dimensions demonstrate that there has been little substantive change in the organization and delivery of primary care over 10 years in Ontario.

Conclusions: Primary care reform is a multi-dimensional construct with different reform models bundling core dimensions in different ways. This understanding is important to move beyond the rhetoric of “reform” and to critically assess the pace and direction of change in primary care in Ontario and in other jurisdictions. The conceptual framework developed in this paper can assist decision-makers, academics and health care providers in all jurisdictions in evaluating the pace of change in the primary care sector, as well as other sectors.

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Research Article

ArticleID :IJNR/2020/06/02/01

A Study to Assess the Quality of Life among Caregivers of Patients of Schizophrenia in a Tertiary Care Centre of Western Maharashtra

Issue No. 02 (Apr-June)

Authors: Deepika Sheroun, Radhika Das

Introduction: Treatment of the chronic mentally ill like patients of schizophrenia, mainly focuses on the patient and the caregivers get no attention. In bargain to providing care to patients, these caregivers experience poor quality of life (QOL). 

Aims and Methods: The present paper reports on the QOL of caregivers of schizophrenia patients attending the OPD of a tertiary care center in, Maharashtra India. Thirty caregivers were selected, with age between 20 and 50 years and providing care for more than 1 year after taking consent from them. Data were collected using WHOQOL BrefScale.

Results: The four domains – physical health, social relationship, psychological, and environmental factors, were used to understand the QOL of the caregivers. The domain with the highest score was environmental factors (mean is 59.7), which consists of the following factors: Financial resources freedom, physical safety, and security health and social care, opportunities for acquiring new information, etc. The domain with the least score was physical health (54.65), related with the following factors – activities of daily living, fatigue mobility pain, discomfort sleep, and rest work capacity. Psychological and social relationship scores were 58.2 and 59.0, respectively. 

Conclusion: In this study, the QOL of these caregivers was obtained lowest in the physical domain. It is evident that the caregivers suffer from fatigue, insomnia, andtheir activities of daily living are hampered in the behest of caring for their loved one.

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Research Article

ArticleID :IJNR/2020/06/02/02

Quarantine Perception during Lockdown in View of COVID – 19

Issue No. 02 (Apr-June)

Authors: R. Regi Bai, D. Mohanalakshmi

Background: Novel Coronavirus disease (COVID-19) originating from China on December 2019 has rapidly crossed borders, infecting people throughout the whole world. This phenomenon has led to a massive public reaction; the media have been reporting continuously across borders to keep all informed about the pandemic situation. A public health measure to prevent the spread of this disease is quarantine. The public has increased level of anxiety and fewer attitudes toward quarantine even though the government is focusing a lot on it. 

Aim: This study attempted to assess the perception of quarantine among the nursing students during the COVID-19 pandemic. Materials and Methods: A survey was conducted using a questionnaire to assess the perception of quarantine. A total of 90 samples were selected randomly as first responders to the questionnaire. The questionnaire was distributed with the use of email and whatsApp. 

Results: The majority of the students strongly agree or somewhat agree for the quarantine practices in four subscale of justification, sanction, burden, and safeguard. About 97% of the samples strongly agree that the public health authority needs to explain the importance of quarantine. 

Conclusion: During this pandemic, most of the educated people and health professionals are aware of this infection, possible preventive measures, the importance of social distancing and government initiatives were taken to limit the spread of infection.

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Research Article

ArticleID :IJNR/2020/06/02/03

COVID-19 Knowledge and Perception among Budding Nurses: A Questionnaire-Based Survey

Issue No. 02 (Apr-June)

Authors: Kuldeep Patidar, Maneesh Sharma, Ashish Gautam, Dinesh K. Sharma, Jayesh Jain

Background and Aim: In COVID-19 pandemic, a global emergency, there is a scarcity of resources including workforce in health-care system. Budding nurses as additional workforce are being utilized in COVID-19 units, where their knowledge and perception about COVID-19 plays a key role in patient care as well as for their safety. There is a paucity of regional data on knowledge and perception of budding nurses about COVID-19. The present study was conducted with an aim to assess the knowledge and perception of budding nurses about COVID-19. 

Materials and Methods: In this online survey, 380 budding nurses participated. A 26-item semi-structured (9) knowledge and (10) perception-based questionnaire was responded by participants. Descriptive and inferential statistics were used to analyze the findings. 

Results: A significant number of participants were passably aware of the basic element of COVID-19, that is, etiological factor, incubation period, clinical symptoms, transmission, prevention, and treatments and majority (52.89%) budding nurses have shown positive perception toward COVID-19. 

Conclusion: The findings of this study revealed that knowledge and perception of budding nurses were significantly adequate and positive about COVID-19; however, in some areas, there was a substantial gap in knowledge; hence, periodic educational sessions regarding COVID-19 to budding nurses will help in curtailing the gap and they can be utilized as a better resource in a time of pandemic to overcome the shortage of manpower.

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Research Article

ArticleID :IJNR/2020/06/02/04

Effectiveness of Structured Teaching Programme on Knowledge Regarding Maintenance of Warm Chain in Prevention of Hypothermia in Newborn Babies: A Quasi-experimental Study

Issue No. 02 (Apr-June)

Authors: Pooja Thakur, Amita Puri, Reena Dogra

Background: Hypothermia is common in newborn born at hospitals (prevalence range, 32–85%) and homes (prevalence range, 11–92%), even in tropical environments. The lack of thermal protection is still an underappreciated major challenge for newborn survival in developing countries. 

Aim: The main was to assess the effectiveness of structured teaching programme (STP) on knowledge regarding maintenance of warm chain in the prevention of hypothermia in newborn babies among B.Sc. Nursing 4th-year students. 

Methodology: A quasi-experimental research design was used. A total of 116 students of B.Sc Nursing 4th-year were selected through convenient sampling. Self-structured questionnaire comprised 35 questions was used. After pre-test, STP was provided to the samples using powerpoint presentations. The post-test was conducted thereafter and knowledge scores of both pre-test and pot-test were compared. 

Results: In pre-test experimental group, 51 (87.9%) had average knowledge, 7 (12.1%) had below-average knowledge, whereas in post-test experimental group, 56 (96.6%) had good knowledge, and 2 (3.4%) had average knowledge. In pre-test control group, 49 (84.5%) had average knowledge, 9 (15.5%) had below-average knowledge, whereas in post-test control group 52 (89.7%) had average knowledge, and 6 (10.3%) had below average knowledge. It was found that there is significant change in post-test knowledge score of the experimental group with t value 62.916 at the degree of freedom at 57 at 0.05 level of significance. 

Conclusion: The findings concluded that the STP was effective in increasing knowledge of B.Sc nursing 4th-year students.

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Research Article

ArticleID :IJNR/2020/06/02/05

A Study to Assess Knowledge and Attitude of Prevention of Female Feticide among Newly Married Couples in Sangli and Satara District

Issue No. 02 (Apr-June)

Authors: Sunil Kulkarni, Satish Salvi, Rohini Dani

Background: At present, female feticide is burning issue in over the entire world. Indian constitution says that gender equality is the fundamental right of every Indian. Scenario shows cruel face. Female feticide is widely occurred in India.

Objectives: The objectives of the study were to assess existing knowledge and attitude regarding prevention of female among newly married couples in Sangli and Satara district. 

Methodology: The research design was analytical survey method. Settings of the study were Sangli and Satara district. Population of the study selected for the study comprised newly married couples staying in Sangli and Satara district. Sampling technique used was convenient, non-probability technique. Sample size was 50 married couples from each district. Method of data collection used structured interview schedule. Content validity of the tool was done by 14 experts from nursing, medical, language, legal, police, and education fields. Reliability was done with split-half technique r’ = 81 (wife knowledge and attitude) r’ = 0.9 (husband knowledge and attitude). Correlation coefficient r’ > 0.8 was observed. 

Results: Wives and husbands had almost equal knowledge of the prevention of female feticide. Still 40% of subjects had not correct knowledge of the prevention of female feticide. Wives and husbands from Satara district had more desired attitude of the prevention of female feticide than Sangli district. 

Conclusion: Female feticide is big burning issue. It is multifactorial. Change in social system and social attitude will be the main measure. Every married couple will play a key role it.

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Research Article

ArticleID :IJNR/2020/06/02/06

A Study to Assess the Effectiveness of Epsom Salt Hot Water Application and Plain Hot Water Application to Reduce Knee Joint Pain Among Old Age People in Selected Old Age Homes in Rajahmundry

Issue No. 02 (Apr-June)

Authors: K. Samayochitha, B. Geetha Praveena

Background: Injury or damage to a joint can involve any of these structures and because of this; it is sometimes difficult to be precise as to which of these are the cause of pain. 

Objectives: The objectives of the study were to assess the pre-test level of pain scores in both the experimental group and control group, to administer the Epsom salt hot water application in the experimental group, to administer the plain hot water application in the control group, to assess the post-test level of pain scores in both the experimental group and control group, to compare the pre-test and post-test level of pain scores in the experimental group, to compare the post-test scores between both the experimental and control group, and to find out the association between the experimental group with their selected demographic variables. 

Materials and Methods: The setting was the physical location and conditions where data collection takes place in the study. The present study was conducting pain scores at Sri Gowthami Jeeva Karunya old age home, Lalacheruvu, Rajahmundry. The sample for the present study consists of old age people. The sample size consists of 60 clients. The sample will be divided into two groups. The experimental group consists of 30 clients and the control group consists of 30 clients. 

Results: With regard to age in the experimental group, eight samples were in the age group of 55 years, seven samples were in the age group of 56–59 years, and 15 samples were in the age group of 60 years and above. In the control group, 26 samples were in the age group of 55 years. Eleven samples were in the age group of 56–59 years and 11 samples were in the age group of 60 years and above. 

Conclusion: From the study finding, it is concluded that Epsom salt hot water application is effective in reducing knee joint pain among old age people.

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Research Article

ArticleID :IJNR/2020/06/02/07

Are Malaysian Type 2 Diabetes patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures?

Issue No. 02 (Apr-June)

Authors: Siti Fatimah Badlishah-Sham, Anis Safura Ramli, Mohamad Rodi Isa, Nurzakiah Mohd-Zaki and David Leonard Whitford

Background: Offspring of type 2 diabetes patients have an absolute risk of 20–40% of developing the condition. Type 2 diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training.

Methods: This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression (MLogR).

Results: A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having the correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age ≥ 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement ‘I do not have much contact with my offspring’ [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement ‘my offspring are not open to advice from me’ [Adj. OR: 0.63 (95% CI: 0.31, 0.84].

Conclusion: The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.

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Research Article

ArticleID :IJNR/2020/06/02/08

Communication between general practitioners and medical specialists in the referral process: a cross-sectional survey in 34 countries

Issue No. 02 (Apr-June)

Authors: Giacomo Scaioli, Willemijn L. A. Schäfer, Wienke G. W. Boerma, Peter M. M. Spreeuwenberg, François G. Schellevis and Peter P. Groenewegen

Background: The communication of relevant patient information between general practitioners (GPs) and medical specialists is important in order to avoid fragmentation of care thus achieving a higher quality of care and ensuring physicians’ and patients’ satisfaction. However, this communication is often not carried out properly. The objective of this study is to assess whether communication between GPs and medical specialists in the referral process is associated with the organisation of primary care within a country, the characteristics of the GPs, and the characteristics of the primary care practices themselves.

Methods: An analysis of a cross-sectional survey among GPs in 34 countries was conducted. The odds ratios of the features that were expected to relate to higher rates of referral letters sent and communications fed back to GPs were calculated using ordered logistic multilevel models.

Results: A total of 7183 GPs from 34 countries were surveyed. Variations between countries in referral letters sent and feedback communication received did occur. Little of the variance between countries could be explained. GPs stated that they send more referral letters, and receive more feedback communications from medical specialists, in countries where they act as gatekeepers, and when, in general, they interact more with specialists. GPs reported higher use of referral letters when they had a secretary and/or a nurse in their practice, used health information technologies, and had greater job satisfaction.

Conclusions: There are large differences in communication between GPs and medical specialists. These differences can partly be explained by characteristics of the country, the GP and the primary care practice. Further studies should also take the organisation of secondary care into account.

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Research Article

ArticleID :IJNR/2020/06/02/09

Factors influencing termination of resuscitation in children: a qualitative analysis

Issue No. 02 (Apr-June)

Authors: Rashida T. Campwala, Anita R. Schmidt, Todd P. Chang and Alan L. Nager

Background: Pediatric Advanced Life Support provides guidelines for resuscitating children in cardiopulmonary arrest. However, the role physicians’ attitudes and beliefs play in decision-making when terminating resuscitation has not been fully investigated. This study aims to identify and explore the vital “non-medical” considerations surrounding the decision to terminate efforts by U.S.-based Pediatric Emergency Medicine (PEM) physicians.

Methods: A phenomenological qualitative study was conducted using PEM physician experiences in terminating resuscitation within a large freestanding children’s hospital. Semi-structured interviews were conducted with 17 physicians, sampled purposively for their relevant content experience, and continued until the point of content saturation. Resulting data were coded using conventional content analysis by 2 coders; intercoder reliability was calculated as κ of 0.91. Coding disagreements were resolved through consultation with other authors.

Results: Coding yielded 5 broad categories of “non-medical” factors that influenced physicians’ decision to terminate resuscitation: legal and financial, parent-related, patient-related, physician-related, and resuscitation. When relevant, each factor was assigned a directionality tag indicating whether the factor influenced physicians to terminate a resuscitation, prolong a resuscitation, or not consider resuscitation. Seventy-eight unique factors were identified, 49 of which were defined by the research team as notable due to the frequency of their mention or novelty of concept.

Conclusion: Physicians consider numerous “non-medical” factors when terminating pediatric resuscitative efforts. Factors are tied largely to individual beliefs, attitudes, and values, and likely contribute to variability in practice. An increased understanding of the uncertainty that exists around termination of resuscitation may help physicians in objective clinical decision-making in similar situations.

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Research Article

ArticleID :IJNR/2020/06/03/01

Effectiveness of Nurse Led-home Based Diabetic Management Program on Glycemic Control and Quality of life of People Living with Diabetes: A Systematic Review

Issue No. 03 (July-Sept)

Authors: Uma J. Deaver, Sarin Jyoti

Background: Diabetes mellitus (DM) is common medical condition which is prevalent among all the age groups due to which the quality of life (QOL) of the individuals gets affected. With this background, systematic literature search and meta analysis were carried out. 

Objective: The objective of the study was to assess the effectiveness of nurse led-home based diabetic management program (N-HBDMP) on glycemic control and QOL among people living with diabetes (PLD), with particular focus on its efficacy as an adjunctive treatment. 

Materials and Methods: Reviewers searched nine databases for systematic reviews published in English language peer-reviewed journals between 2005 and 2018. Systematically, the search of significant articles was carried out in various search engines with the following key words: “PLD,” “Glycemic Control,” “QOL,” and “N-HBDMP.” Results were narrated and synthesized. 

Results: Thirty-five papers were retrieved from the search. Among them, 25 were evaluated to be of higher quality. Studies recruiting samples of diabetic people with type 2 DM, with various risk factors or those who were dependent on care were insufficient according to high incidence rate of T2DM. 

Conclusion: The incidence of T2DM, its related symptoms, and its complications can be reduced by the N-HBDMP which deals with controlling the glycemic level and improving the QOL of PLD.

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Research Article

ArticleID :IJNR/2020/06/03/02

Effect of Planned Early Ambulation on Psychophysical Well-being of Post-cesarean Patients

Issue No. 03 (July-Sept)

Authors: Jyoti Rajesh Thakur

Introduction: As the well-being of maternal and child health occupies paramount place in health-care delivery system, cesarean section (CS) has become the most common intervention in obstetrics discipline. Since the past 25 years, factors such as medical, psychological, social, financial, and legal seem to have contributed to rise in CS rates. In spite of changes in its indications, CS is currently performed to benefit the fetus, not the mother. The present study aimed to study the effect of planned early ambulation on post-cesarean patients. 

Materials and Methods: Quasi-experimental approach with preand post-intervention multiple time series study design was adopted. A non-probability purposive sampling technique was used to meet sample size of 500, distributed equally in experimental and control groups. With routine post-cesarean care, planned early ambulation was initiated for the experimental group on the day of LSCS and was followed twice a day for the first 5 post-cesarean days. The study subjects of control group were refrained from this intervention. At the end of each day, the desired data were collected by structured observation and self-report techniques. 

Results: The study subjects of the experimental group had better responses in relation to selected aspect of psychophysical well-being as compared to the control group. The significant difference was noted in the selected aspects of psychophysical well-being among the experimental and control groups. 

Conclusion: The study concluded that planned early ambulation is effective strategy in achieving early psychophysical well-being in post-cesarean patients.

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Research Article

ArticleID :IJNR/2020/06/03/03

Effectiveness of Planned Teaching Program on Knowledge of Postnatal Mothers Regarding Care of Low Birth Weight Newborns in JK Lon Hospital, Kota (Rajasthan)

Issue No. 03 (July-Sept)

Authors: Mukesh Kumar Meena, Ravikant Sharma

Background and Aim: The birth weight of an infant is the single most important determinant of its chances of survival, healthy growth, and development. One of the factors contributing to infant mortality is low birth weight (LBW).

Aim: The aim of this study was to evaluate the effectiveness of planned teaching program on the care of LBW newborns among postnatal mothers of LBW newborns. 

Materials and Methods: An evaluative research approach with pre experimental design was used for the study. The study was conducted at JK Lon Hospital, Kota. The sample comprised 60 postnatal mothers of LBW newborns. Sample was selected using non-probability convenient sampling technique. Data were collected using a structured knowledge questioner. Data were analyzed using descriptive and inferential statistics. 

Results: The results of this study showed that the mean post-test knowledge score (87.62) also was higher than the mean pre-test knowledge score (48.67). The comparison of pre-test and post-test knowledge score showed that there was a significant gain in knowledge scores of mothers after PTP at 0.05 level (t-value = 16.994, P < 0.05).

Interpretation and Conclusion: The findings of the study concluded that the planned teaching program on care of LBW newborns was highly effective in improving the knowledge of postnatal mothers regarding care of LBW newborns.

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Research Article

ArticleID :IJNR/2020/06/03/04

Effectiveness of stretching exercise to reduce muscle cramps in patients with pulmonary edema

Issue No. 03 (July-Sept)

Authors: K. Soumya, C. V. Sheeja, T. M. Assuma Beevi

Introduction: Patients with pulmonary edema are restricted to bed and usually are very weak. When such patients are experiencing leg cramps, strategies such as walking or warm shower are impracticable. Stretching exercises are known strategies used for relieving muscular strain and muscle spasm. 

Objectives: The objectives of the study were to assess the intensity and frequency of muscle cramps in patients with pulmonary edema and to evaluate the effectiveness of stretching exercise on muscle cramps. 

Materials and Methods: Quantitative research approach with pre-experimental one group pre-test post-test design on 30 patients with pulmonary edema who had muscle cramps > 5 was selected purposively. Data were collected using demographic pro forma, clinical pro forma, modified PSFS scale, and numerical pain intensity scale. Muscle stretching exercise was given for duration of 10 min 8th hourly for 3 times. Intensity of muscle cramp was assessed immediately after the first intervention and the frequency of muscle cramp was reassessed 8 h after third intervention. 

Results: The muscle cramp intensity showed a total of 100% had severe pain before the intervention. About 73.3% had mild and 26.7% had moderate intensity after the intervention. The paired “‘t” value was 2.05 with P = 0.001 which was highly significant at 0.05 level after undergoing stretching exercise. 

Conclusion: The findings concluded that stretching exercise was effective in reducing the muscle cramp. Patients in ICUs are experiencing pain and cramp. Simple and cost effective exercises will be useful in reducing pain and improve the quality of nursing care.

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Research Article

ArticleID :IJNR/2020/06/03/05

Effectiveness of an Information, Education, and Communication Package on Compliance to Glaucoma Medication among Caregivers of Childhood Glaucoma

Issue No. 03 (July-Sept)

Authors: T. Thuileiphy, Cecilia Mary Susaimuthu, Dewang Angmo, Ramanjit Sihota

Aim: Patient education is important for building patients’ knowledge, practice, and self-management. The purpose of this study is to assess the effectiveness of information, education, and communication (IEC) package in educating caregivers of pediatric glaucoma. 

Methodology: In this prospective interventional study done at the ophthalmology department of a tertiary care hospital, a validated IEC package was administered to 60 caregivers of children attending a glaucoma clinic through interactive teaching sessions, demonstration, and return demonstration. Knowledge and practice questionnaires, observational checklist, and medication log sheets were used during the pre-test and one month after administration of IEC package (post-test). 

Results: The majority of the caregivers were female; the mean post-test knowledge score increased significantly, P = 0.0001. There was a significant increase in the post-test practice score, P = 0.0001. The pretest and the post-test knowledge scores had a significant association with educational status, P = 0.001, family monthly income, P = 0.001. The pre-test and the post-test practice scores had a significant association with gender, P = 0.004 and relationship to child, P = 0.003. 

Conclusion: This study revealed that an IEC package and short teaching session significantly increased the knowledge and practice of caregivers.

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Review Article

ArticleID :IJNR/2020/06/03/06

Potential benefits of integrating ecological momentary assessment data into mHealth care systems

Issue No. 03 (July-Sept)

Authors: Jinhyuk Kim, David Marcusson-Clavertz, Kazuhiro Yoshiuchi and Joshua M. Smyth

The advancement of wearable/ambulatory technologies has brought a huge change to data collection frameworks in recent decades. Mobile health (mHealth) care platforms, which utilize ambulatory devices to collect naturalistic and often intensively sampled data, produce innovative information of potential clinical relevance. For example, such data can inform clinical study design, recruitment approach, data analysis, and delivery of both “traditional” and novel (e.g., mHealth) interventions. We provide a conceptual overview of how data measured continuously or repeatedly via mobile devices (e.g., smartphone and body sensors) in daily life could be fruitfully used within a mHealth care system. We highlight the potential benefits of integrating ecological momentary assessment (EMA) into mHealth platforms for collecting, processing, and modeling data, and delivering and evaluating novel interventions in everyday life. Although the data obtained from EMA and related approaches may hold great potential benefits for mHealth care system, there are also implementation challenges; we briefly discuss thechallenges to integrating EMA into mHealth care system.

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Research Article

ArticleID :IJNR/2020/06/03/07

Validation of a childhood eating disorder outcome scale

Issue No. 03 (July-Sept)

Authors: Shinichiro Nagamitsu, Yoshimitsu Fukai, So Uchida, Michiko Matsuoka, Toshiyuki Iguchi, Ayumi Okada

We developed and validated a childhood eating disorder outcome scale based on outcomes associated with body mass index standard deviation score (BMI-SDS). This prospective observational study included 131 children with eating disorders (aged 5–15 years). Participants’ outcomes scales were completed at the first visit and at 1, 3, 6, and 12 months. The scale evaluated 12 outcomes: body weight change (BW), eating attitude (EA), fear of being fat (FF), body image distortion (BD), menstruation (ME), perceived physical condition (PC), attending school (AS), disease recognition by school (RS), family function (FA), disease recognition by parent (RP), social adaptation (SA), and relationships with friends (RF). Responses to all items were on a four-point Likert scale. Exploratory factor analysis was used to determine the number of factors based on the 12 outcomes. The relation between outcome scale scores and BMI-SDS over the 12-month follow-up period was analyzed. Two types of factors were extracted: disease-specific factors (EA, FF, BD) and biopsychosocial factors (BW, PC, AS, FA, SA, RF). Three items (ME, RS, RP) were excluded because they showed no significant loading effect. There was a significant negative correlation between the outcome scale and BMI-SDS, and changes in outcome scale scores from baseline to 12 months were significantly associated with improvement in BMI-SDS. We developed a childhood eating disorder outcome scale characterized by disease-specific and biopsychosocial factors. Biopsychosocial management combined with a therapeutic approach for disease-specific symptoms may support body weight recovery for children with eatingdisorders.

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Review Article

ArticleID :IJNR/2020/06/03/08

The effectiveness of intervention with board games: a systematic review

Issue No. 03 (July-Sept)

Authors: Shota Noda, Kentaro Shirotsuki and Mutsuhiro Nakao

To examine the effectiveness of board games and programs that use board games, the present study conducted a systematic review using the PsycINFO and PubMed databases with the keywords “board game” AND “trial;” in total, 71 studies were identified. Of these 71 studies, 27 satisfied the inclusion criteria in terms of program content, intervention style, and pre–post comparisons and were subsequently reviewed. These 27 studies were divided intothe following three categories regarding the effects of board games and programs that use board games: educational knowledge (11 articles), cognitive functions (11 articles), and other conditions (five articles). The effect sizes between pre- and post-tests or pre-tests and follow-up tests were 0.12–1.81 for educational knowledge, 0.04– 2.60 and − 1.14 – − 0.02 for cognitive functions, 0.06–0.65 for physical activity, and − 0.87 – − 0.61 for symptoms of attention-deficit hyperactivity disorder (ADHD). The present findings showed that, as a tool, board games can be expected to improve the understanding of knowledge, enhance interpersonal interactions among participants, and increase the motivation of participants. However, because the number of published studies in this area remains limited, the possibility of using board games as treatment for clinical symptoms requires further discussion.

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Review Article

ArticleID :IJNR/2020/06/04/01

Mindfulness for Professional Caregivers of Coronavirus Disease-19- Positive Patients – A Realistic Need of the Hour

Issue No. 04 (Oct-Dec)

Authors: Krishnan Sivasubramoney, Kothandaraman Lekshmy

Humankind has witnessed many natural and self-created traumatic events in its history. Among these, pandemics withmajor losses in terms of human force and other resources need special mention. The current situation of coronavirus disease (COVID-19) is one such. Most often health-care professionals (HCPs) who are the sole caregivers for patients with COVID-19 patients are at increased risk for infection and consequences more than general public. Extended working hours, changes in the mode of care, use of personal protection equipment, change of working and social environment, plummeting financial conditions, stressors within the family or in the personal life, and many such factors predispose HCPs to acute and ongoing stress. This is in addition to the routine stressors which any human being has exposure to. Often, this leads to adoption of inadequate and unscientific coping strategies with disastrous consequences in the long run. This article tries to elucidate on the utility and efficacy of mind fulness based interventions (MBIs) to enhance the resilience and psychological wellbeing of HCPs since subjective negative emotional states and inability to use life skills appropriately may accentuate the problems health care workers face in the taxing times of COVID-19 pandemic. MBIs have ample evidences to prove its effect in strengthening logical and emotional functions of brain to increase the resilience of practitioner. HCPs are the workforce of any country which need to adapt to changing situations and adopt the optimized methods and systems to meet the needs of patients, families, and society at large. Burnout is very common among these strata of professionals. Managing professional life and personal life in balance require added skills which mindfulness training can impart. Burnout, compassion fatigue, and post-traumatic stress disorder like problems which may get precipitated during the COVID-19 period may also be managed by MBIs.

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Review Article

ArticleID :IJNR/2020/06/04/02

Fitz-Hugh-Curtis Syndrome: A Comprehensive Review

Issue No. 04 (Oct-Dec)

Authors: Santosh Kumari, Jasbir Kaur, Poonam Sheoran, Shaweta Sharma

Fitz-Hugh-Curtis syndrome (FHCS) is a rare disorder that occurs in women. FHCS is a chronic manifestation of pelvicinflammatory disease (PID). It is characterized by inflammation of the membrane lining the stomach (peritoneum) and the tissues surrounding the liver (perihepatitis). The majority of cases occur in women of reproductive age between 15 and 30 years of age who have PID. Approximately 4–14% of women with PIDs develop FHCS. It occurs with greater frequency in adolescents with PIDs because they are more susceptible to infection. In extremely rare cases, it has occurred in men. PIDs are an ascending microbial infection involving the genital tract that affects sexually active. The United States experiences 750,000 cases of PID each year. FHCS is an uncommon manifestation of PIDs involving around 4% of adolescents. According to a case report, a 23-year-old girl found with FHCS at Bombay Hospital and Institute of Medical Sciences, Mumbai, Maharashtra, India. Many organisms are associated with FHCS, Chlamydia trachomatis is the most common pathogen involved. Common symptoms include severe pain in the upper right area (quadrant) of the abdomen, fever, chills, headaches, and a general feeling of poor health (malaise). There are insufficient data documenting the prognosis of FHCS as it usually responds to antibiotics very well. In one trial of triple therapy (penicillin-gentamicin-metronidazole) versus Augmentin for non-chlamydial salpingitis, only one patient in each treatment group had treatment failure.

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Review Article

ArticleID :IJNR/2020/06/04/03

Pathophysiology, Prevalence, and Management of Iron Deficiency Anemia

Issue No. 04 (Oct-Dec)

Authors: Deepali Ugle, Avani Bhanage, S. S. Ugle, Ekta Shinde

Anemia is a major killer in India. Statistics reveal that every second Indian woman is anemic. One in every five maternaldeaths is directly due to anemia. Anemia affects both adults and children of both sexes, although pregnant women and adolescent girls are most susceptible and most affected by this disease. Iron deficiency is the most common micronutrient deficiency which affects more than 2 billion population worldwide, leading to anemia in more than 40% of women of reproductive age developed countries. The prevalence of anemia among adolescent is more than 25% in developing countries. Globally, anemia affects 1.6 billion people which correspond to 24.8% of the population. The highest prevalence is in the preschool age children 47.4%, prevalence in men is 12.7% the groups with higher prevalence are, infants and children of 1–2 years 48%, School children are about 40%, non-pregnant women 35%, adolescents 30–55%, and preschool children 25%. The prevalence of anemia in developing countries is about 4 times than those of developed countries. Asia has the highest rates of anemia in the world. About half of the world’s anemic women live in Indian subcontinent and 88% of them develop anemia during pregnancy. The situation in Asia has not improved in recent years. Almost all individuals will be iron deficient except possibly if the anemia is caused predominantly by malaria. This review contains detailed information about types and prevalence of anemia, including special emphasis of pathophysiological aspects and treatment management of iron deficiency anemia.

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Research Article

ArticleID :IJNR/2020/06/04/04

A Study to Assess the Caregiver Burden of the Caregivers of Post- Operative Patients with Oral Cancer in B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi

Issue No. 04 (Oct-Dec)

Authors: Neenumol Paulose, Aditi Prashant Sinha, S. V. S. Deo

Introduction: Cancer is a leading cause of death in both developed and underdeveloped countries. The Indian subcontinent accounts for one-third of the world burden of head-and-neck cancer. Caregivers of patients with oral cavity cancer experience heavy burden during and post-treatment period, which, in turn, may affect the caregiver’s ability. 

Aim: This study aims to assess the caregiver burden (CB) of the caregivers of post-operative oral cancer patients.

Methodology: The study was conducted at AIIMS, New Delhi. The data were collected by convenience sampling from 50 caregivers of the post-operative patients with oral cancer during June 2017 to December 2017. Self-developed CB assessment questionnaire was used to assess the perceived level of the CB during hospital stay and at 1 month follow-up. Ethical clearance was obtained from the Institutional Ethics Committee. 

Results: Half of the caregivers were male and half were female. Majority of the caregivers always perceived physical problem (70%, 55.8%), emotional problem (60%, 52.9%), logistical problem (64%, 55.88%), inadequate knowledge and skill (66%, 64.7%), and socioeconomic problem (56%, 73.5%) during hospital stay and 1 month follow-up, respectively. There was a significant decrease in the overall CB at 1 month follow-up (17.16 ± 8.19 and 14.96 ± 9.87) (P = 0.04). 

Conclusions: Reduction in CB was noted over the month. Future studies with larger sample over extended period will yield much.

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Research Article

ArticleID :IJNR/2020/06/04/05

An Experimental Study to Assess the Effectiveness of Progressive Muscle Relaxation Technique on Post-operative Pain Management in Patients Undergoing Abdominal Surgery in Gauhati Medical College and Hospital, Guwahati, Assam

Issue No. 04 (Oct-Dec)

Authors: Rukiya Nabiya Ahmed

Background: Effective pain management is essential in the post-operative period to ensure that patients do not experience unnecessary distress or suffering and to minimize potential complications. One of the most simple and easy learned techniques for relaxation is progressive muscle relaxation (PMR) technique. 

Aim: This study aims to assess the effectiveness of PMR technique on post-operative pain management in patients undergoing abdominal surgery in Gauhati Medical College and Hospital, Guwahati, Assam. 

Materials and Methods: A quasi-experimental, pretest-post-test control group design was selected for the study. Convenient sampling technique was used to select 40 patients in the experimental and control groups by simple randomization. 

Analysis and interpretation: Results: The findings of the study revealed that on pre-test assessment, it was observed that in day 1, majority of patients had moderate pain both in the experimental and control groups, that is, 90% and 85%, respectively. In day 2 also, majority of patients in both the experimental group and control group had moderate pain, that is, 75% and 65%, respectively. In day 3, majority of patients had mild pain in both the experimental group and control group, that is, 95% and 85%, respectively. It was found that there was no significant association between the selected variables and level of pain in patients undergoing abdominal surgery. The pre-test and post-test observation on the 1st and 2nd post-operative day by paired t-test was significant (P < 0.05) in the experimental group. On the 3rd post-operative day, t value was significant in both the experimental and control groups (P < 0.01). 

Conclusion: It can be concluded that PMR technique was effective in reducing level of post-operative pain on the 1st and 2nd post-operative days after abdominal surgery.

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Research Article

ArticleID :IJNR/2020/06/04/06

Comparative Analysis of Depression, Anxiety, and Stress Scores among Nurses in Different Departments from a Single Center in North India

Issue No. 04 (Oct-Dec)

Authors: Manishi Bansal, Ankush Jindal, Rashika Walia, Anupam Jindal, Rimple Gupta

Introduction: Mental health of health care workers is of utmost importance as they are at high risk of psychological problems due to the demanding nature of their profession. Periodic assessment of nurse’s mental health should be of priority so that timely measures can be taken. 

Aims and Objectives: This study was conducted with the aim to assess – (1) the prevalence of depression, anxiety, and stress among intensive care unit (ICU), operation theater (OT), and inpatient ward (IPD) nurses, (2) to compare the levels of depression, anxiety, and stress within departments, and (3) to correlate the level of above parameters with certain variables. 

Materials and Methods: A cross-sectional study was conducted at Mayo Super Specialty Hospital, India. A total of 90 nursing staffs were interviewed regarding incidence of depression, anxiety, and stress using a DASS pro forma. The scores were then interpreted according to the categories given in the pro forma. 

Results: Out of the 90 study participants, 30 were male and 60 were female. Average age was 29 years. The overall prevalence of depression in ICU, OT, and IPD was 53.3%, 33.3%, and 40%, respectively. The incidence of anxiety was 73.3% and stress was 40% in ICU which was higher than OT and IPD areas. However, the above differences were not statistically significant. 

Conclusion: Our study demonstrates that levels of depression, anxiety, and stress were higher among nursing staff of ICU as compared to other areas within the same hospital and timely preventive measures should be taken to avoid any serious mental illness.

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Research Article

ArticleID :IJNR/2020/06/04/07

Perception of Patient Regarding Nurse Patient Communication Barrier: A Case of Chitwan Medical College, Chitwan

Issue No. 04 (Oct-Dec)

Authors: Gita Dhungana, Bedantakala Thulung, Surya Mani Dhungana

Aim and Objective: Nurse patient communication is one of the important factors in providing an effective and quality nursing care and services. The objective of the study was to assess the level of nurse-patient communication barriers as perceived by patient at teaching hospital. 

Methods: The study has followed the quantitative descriptive cross-sectional design and has used the – semi structured interview schedule along with Likert rating scale ranging from five to one. Complete enumeration technique was used. Total patients 201 were selected from general wards having at least 3 days hospital stay. The study has utilized the data analysis tools such as EpiData, SPSS version 21 to analyze the information using descriptive and inferential statistics. They are common factors, nurse related factors, patients related factors, and environment-related factors. 

Results: The study revealed that more than 50% of patients were male with the average 40.64 ± 14.75. About 78.10% of patients told that most barriers during nurse-patients communication. Among four factors patient related factors (3.77 ± 0.55), nurse related barrier (3.29 ± 0.59), environmental barrier (3.12 ± 0.23), and common barrier (2.73 ± 0.79) were the most and least important factors, respectively. Language difference (mean score 3.38), inadequate explanation about procedure or treatment by nurse (mean score 4.07), and among them hearing problems (mean score 4.81), noisy environment (mean score 4.09) were major barrier subfactors while communication between patient and nurse. 

Conclusion: It is concluded that the majority of patients had perceived level of barriers in overall as most barriers. Finally, the study has recommended that in-service education, effective supervision and reinforcement scheme, development, and utilization of guidelines for nurse-patients communication.

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Research Article

ArticleID :IJNR/2020/06/04/08

“Effectiveness of Structured Teaching Program on Knowledge Regarding Renal Care (Dialysis) at Home among the Caregivers of Renal Failure Patient”

Issue No. 04 (Oct-Dec)

Authors: Hardik Pandya, Shalini Raj Kumawat

Background: Chronic kidney disease poses a threat to the health care system. Dialysis saves patient life. Patients on dialysis patient have a greater chance for increased survival time owing to the advances in treatment modalities; therefore, more comprehensive information to understand the aspects of renal care is very important. 

Aim and Objective: The objective of the study was to assess the pre- and post-test knowledge score regarding renal care (dialysis patient) and to evaluate the effectiveness of structured teaching program (STP) on renal care (dialysis patient) at home among caregivers. 

Materials and Methods: An evaluative research approach with a pre-experimental design was used for the study. The study was conducted on 60 samples at caregivers of renal patients at selected hospitals of Udaipur city. Sample was selected by non-probability convenient sampling technique. Data were collected using a self-structured questionnaire. 

Statistical Analysis Used: Descriptive and inferential statistics were used for interpretation and analysis of data. 

Results: The findings of the present study showed that the highest percentage (61.7%) of caregivers belonged to the age group of 26–35. The mean post-test knowledge score (22.86) also was higher than the mean pre-test knowledge score (10.35). The comparison of pre-test and post-test knowledge score showed that there was a significant gain in knowledge scores of caregivers after STP at 0.05 level (t =7.41, P < 0.05). This shows that a STP was effective. 

Conclusions: The study findings concluded that caregivers had inadequate knowledge regarding renal care before STP. After giving structured teaching programme patients and care givers had greater potential for accelerating awareness regarding home based renal care.

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Research Article

ArticleID :IJNR/2020/06/04/09

Effectiveness of Planned Teaching Program on Knowledge Related to Diaper Dermatitis among the Mothers

Issue No. 04 (Oct-Dec)

Authors: Aparna B. Kale

Aim: The aim of this study was to assess the effectiveness of planned teaching program on knowledge related to diaper dermatitis among the mothers. 

Introduction: Diaper dermatitis is also known as diaper rash. Almost every mother and child has had some experience with diaper rash at some time. To many 1st-time mothers, a case of diaper rash may shake their confidence in their ability to be an adequate mother and to care for their infant. 

Objective: The present study was carried out to assess the pre-existing knowledge related to diaper dermatitis among the mothers of children age (0–1 year) and effectiveness of planned teaching program on knowledge related to diaper dermatitis. 

Methodology: The research design used was one group pre-test – post-test design to collect the sample constitutes; 70 mothers of children (0–1 year) in pediatric unit of selected hospitals from Sangli-Miraj Area. 

Results: Results of present study shown that the knowledge of the mothers of pre-test mean score is 8.08, standard deviation is 1.79, and in post-test mean score is 12.17, standard deviation is 1.65, t = 35.64 and P = 0.000, that is, it is highly significant as P < 0.005; therefore, there is increasein the knowledge score after planned teaching program. 

Conclusion: The present study shows that the planned teaching program was effective. The study findings could be utilized in various matter as well and recommended in developing better manner.

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Research Article

ArticleID :IJNR/2020/06/04/10

A Correlational Study on Oral Health and Oral Health-Related Quality of Life among Older Adults Attending Dental Outpatient Department of Selected Community Health Center of D and Nh

Issue No. 04 (Oct-Dec)

Authors: Dharini Parmar, Priya Sharma, Sujeeta Malik

Introduction: Oral health is a key indicator of overall health, well-being, and quality of life (QoL). It encompasses a range of diseases and conditions that include dental caries, periodontal disease, tooth loss, oral cancer, oral manifestations of HIV infection, and or dental trauma. 

Aim: The aim of the study was to correlate oral health and oral health-related QoL among older adults attending dental outpatient department of selected community health center of Dadra and Nagar Haveli. 

Materials and Methods: Survey approach was used to determine the correlation between oral health and oral health-related QoL among older adults. A descriptive correlational study design was adopted for conducting the study. The sample for the study was 165 older adults aged 50 years and above who have oral diseases/problem which were selected by non-probability purposive sampling technique. Structured Questionnaire on Demographic characteristics was developed by investigator for the purpose of collecting background information of the sample. Observational checklist was used to assess oral health status of older adults. Oral health impact profile (OHIP-14) tool was adopted to assess behavior on oral health status. 

Results: A total of 165 subjects were interviewed and examined. All were favorable to participate in this research study on level of oral health. There is low impact profile on level of oral health-related QoL. There is highly significant (P < 0.001***) correlation between oral health and oral health-related QoL among older adults with r-value of 0.4176. 

Conclusion: Hence, the study concludes that OHIP-14 was highly significance correlation between oral health and oral health-related QoL among older adults.

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Research Article

ArticleID :IJNR/2020/06/04/11

“An Experimental Study to Assess the Effectiveness of Planned Teaching Program Regarding Sex Education and Menstrual Hygiene among Students in Selected Secondary School of Ahmednagar, District”

Issue No. 04 (Oct-Dec)

Authors: Jayashree Rajesh Salvi, Shweta Naik

Aim: The aim of this study was to evaluate the effectiveness of planned teaching program regarding sex education and menstrual hygiene. 

Materials and Methods: In the present study, the investigator selected the quasi-experimental design with evaluatorry approach research design, keeping in the view of objectives of the study. A study was conducted in Somaiya Vidyamandir School, Sakharwadi, Ahmednagar district. A study was done on 123 students of Somaiya Vidyamandir School, Sakharwadi. In all boys were 64 and girls were 59. In this study, convenient sampling technique was used. Data were collected using a structured knowledge questioner. The student who were available at the time of data collection and who knew Marathi language and were willing to participate in the study were only included for the data collection. Data were analyzed using descriptive statistics. 

Result: knowledge of girls in pre-test and post-test. Knowledge gain regarding what to be used during menstrual cycle is 50%. Knowledge gain regarding how many times sanitary pads to be changed every day was 60%. Gain in knowledge regarding how many times to wash perineum is 60%. Knowledge gain regarding how to dispose the used sanitary pads or clothes during menstrual cycle is 70% which is maximum. 

Conclusion: Subjects had improvement in knowledge regarding sex education and menstrual hygiene. Sex education and menstrual hygiene session was beneficial for the subjects as they were taught how to maintain hygiene, which will ultimately help the students. Hence, it conclude that planned teaching program is effective.

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Research Article

ArticleID :IJNR/2020/06/04/12

Hemodynamic response to familiar faces in children with ADHD

Issue No. 04 (Oct-Dec)

Authors: Keiichi Shimamura, Takeshi Inoue, Hiroko Ichikawa, Emi Nakato, Yuiko Sakuta, So Kanazawa, Masami K. Yamaguchi, Ryusuke Kakigi and Ryoichi Sakuta

Background: School-age children with attention deficit hyperactivity disorder (ADHD) have difficulties in interpersonal relationships, in addition to impaired facial expression perception and recognition. For successful social interactions, the ability to discriminate between familiar and unfamiliar faces is critical. However, there are no published reports on the recognition of familiar and unfamiliar faces by children with ADHD.

Methods: We evaluated the neural correlates of familiar and unfamiliar facial recognition in children with ADHD compared to typically developing (TD) children. We used functional near-infrared spectroscopy (fNIRS) to measure hemodynamic responses on the bilateral temporal regions while participants looked at photographs of familiar and unfamiliar faces. Nine boys with ADHD and 14 age-matched TD boys participated in the study. fNIRS data were Zscored prior to analysis.

Results: During familiar face processing, TD children only showed significant activity in the late phase, while ADHD children showed significant activity in both the early and late phases. Additionally, the boys with ADHD did not show right hemispheric lateralization to familiar faces.

Conclusions: This study is the first to assess brain activity during familiar face processing in boys with ADHD using fNIRS. These findings of atypical patterns of brain activity in boys with ADHD may be related to social cognitive impairments from ADHD.

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Research Article

ArticleID :IJNR/2021/07/01/01

A Study to Assess the Factors Associated with Delay in Diagnosis of Carcinoma Breast and Carcinoma Oral Cavity among the OPD and IPD Patients at Dr. Bhim Rao Ambedkar, Institute Rotary Cancer Hospital, AIIMS, New Delhi

Issue No. 01 (Jan-Mar)

Authors: Vijayshree Singh, Kamlesh Kumari Sharma, S. V. S. Deo

Aim: This study aims to generate evidence on the extent and type of delay in diagnosis of carcinoma breast and oral cavity so as to provide ground for addressing the underlying issues. 

Materials and Methods: This quantitative descriptive study was conducted; data were collected by consecutive sampling from 60 carcinoma breast and 60 carcinoma oral cavity patients during July 2017–December 2017; using self-developed semi-structured questionnaire by interview method. All adult newly registered patients who correctly remembered their clinical history were enrolled in the study. Analysis was done using SPSS. Ethical clearance was obtained from the Institutional Ethics Committee. Primary delay is the duration between onset of symptoms till first medical contact while secondary delay is the duration between first medical contacts till final diagnosis with the help of biopsy. 

Results: Primary delay was 30 days (0 days–3650 days) found in 41% of subjects while secondary delay was 60 days (14 days–1095 days) present in 62.5% of subjects. The most common self-reported factor for primary delay and secondary delay was lack of awareness (45.8%) and false assurance (40%), respectively. Worsening of symptoms as reason behind seeking medical help (adjusted odds ratio [OR] 12.71; confidence interval [CI]: 3.5–45.57) and spouses of the head of family (adjusted OR 3.08; CI: 0.99–9.59) are independent predictor for primary delay. Lack of health insurance (OR 3.9; CI 1.24–12.31), negative family history of cancer (OR 2.94; CI 1.14–6.1), and false assurance given by the first medical personnel (OR 13.01; CI 4.4 38.39) are independent predictors of secondary delay. 

Conclusions: Significant delay was present in diagnosis. Both patient and health care workers contribute to these delays.

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Research Article

ArticleID :IJNR/2021/07/02/01

Association of Obesity and Anemia with the Dietary Pattern among the Nursing Students

Issue No. 02 (Apr-June)

Authors: Sukhwinder Kaur, Monika Dutta, Mumtesh Shaktan, Mridula Sharma, Monika Sandhu, Mridu Anand, Monika Devi, Monika Jamwal, Neha Handa

Aim: The aim of the study was to assess the association of obesity and anemia with the dietary pattern among the nursing

students. 

Methodology: A descriptive study was conducted on 87 students of BSc Nursing final year of National Institute of Nursing Education, PGIMER, Chandigarh. Total enumeration sampling technique was used. An interview schedule consisting of socio-demographic profile, dietary pattern questionnaire, food frequency questionnaire, and 2-day recall was used for collecting data. In addition, BMI and hemoglobin levels were measured. 

Result: Among study subjects, nine (10.3%) were obese/overweight, 18 (20.6%) were anemic, and 63 (72.5%) had normal hemoglobin level and BMI. Out of nine obese/overweight subjects, four (44.4%) belonged to high socio-economic class, and six (66.7%) were non vegetarian. Habit of skipping meals was seen both in obese group six (66.7%) and in anemic group 11 (61.1%). The frequency of skipping meals among obese/overweight and anemic subjects was 2–3 meals. Daily consumption of snacks and fast food was also high both in obese/overweight 4 (44.4%) and anemic group 10(55.6%). Only three (33.3%) of obese/overweight group subjects and three (16.6%) of anemic subjects were consuming fruits daily. Calorie intake was high in eight (88.9%) of obesity/overweight group. 

Conclusion: Only the relation of BMI with the calorie intake was seen. People with greater BMI show calorie intake more than the recommended. The association was not assessed due to insufficient sample size. However, only percentages were calculated. Seventy-four (85.1%) subjects were hostellers and 63(72.5%) were still found to have normal BMI and hemoglobin values, thus concluding that they were consuming appropriate diet from the mess.

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