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   Table of Contents - Current issue
Coverpage
July-December 2021
Volume 22 | Issue 2
Page Nos. 107-231

Online since Monday, January 31, 2022

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EDITORIAL  

Publishing a nursing journal – What for? p. 107
Vinitha Ravindran
DOI:10.4103/ijcn.ijcn_123_21  
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CONCEPTS AND ISSUES Top

Obesity and sexual dysfunction among women: An overview p. 109
Princey Shaji, Maharaj Singh, Bharti Sahu
DOI:10.4103/ijcn.ijcn_46_21  
For many obese and overweight women, sexual functioning is a critical, but often ignored, aspect of their quality of life. Obesity is becoming a global problem. The aim of this article was to provide an introductory insight into the relationship between obesity and sexual dysfunction in women from the recent literature. The link between obesity and sexual functioning is poorly understood, and therapeutic choices are even less well understood. Weight did, however, affect the some aspects of sexual function in studies of special populations such as women with gestational diabetes, polycystic ovarian syndrome, pelvic organ prolapse or urinary incontinence. Surgical weight loss, but not non-surgical weight loss is linked to the resolution of some aspects of sexual dysfunction in women. When it comes to sexual dysfunction, women's weight plays a pivotal role. Non-weight loss surgery has been linked to improved sexual function in women. To fully understand the link between weight and sexual function, more research is needed.
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Advancing nursing practice in India: Historical lessons from the United States p. 115
Rajesh Kumar, Tamar W Rodney
DOI:10.4103/ijcn.ijcn_41_21  
Nurses, as key health personnel in the health-care industry, play a vital role in the delivery of care. Nurses work with different populations in varied settings to coordinate care aimed at the prevention of disease, promotion of health and care of sick and dying. With the impending rise in demand for quality care, skilled and specialised role of nurses is paramount to ensure high quality. The creation of advanced nursing roles and specialisation in nursing made the nurses independent and more autonomous in their roles. Advanced roles contributed a service model and best fit to the ever-changing demands of patients. At present, nurses participate in clinical research, decision-making and demonstrate clinical leadership skills to improve the safety and quality of care. Dynamic changes in the health-care industry and consumer awareness are other driving forces that influence the need for nurses to be highly competent and skilled to fulfil their responsibilities. This article briefly describes the nursing transformation in the United States and the different nursing programmes offered in India.
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Mucormycosis in COVID-19 patients: A review p. 123
Khina Sharma, Jyoti , Ramandeep Kaur
DOI:10.4103/ijcn.ijcn_87_21  
Mucormycosis is a rare but invasive, fungal infection mainly found in immunocompromised patients, which occurs due to the fungi mucormycetes. It is a rapidly occurring fungal infection with a high mortality rate. Although rare, the cases of mucormycosis have been raised abnormally in COVID-19 patients in India during second wave, in which a severe rise in COVID-19 cases was reported. Many states of India have already declared it as an epidemic, and the sad part is that the medication to treat it is running low. Mucormycosis has been reported in COVID-19-positive patients at any time after COVID-19 infection, either during hospitalisation or several days to weeks after discharge.
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CLINICAL ARTICLES Top

Collodion baby syndrome: A case study p. 127
Joy Priyadharishini, F Lydia Evelyn
DOI:10.4103/IJCN.IJCN_64_20  
Collodion baby syndrome is a rare congenital autosomal recessive type of ichthyosis. It is a skin disorder characterised by parchment-like taut membrane which is present during birth. Collodion syndrome responds best to medical and nursing measures and may improve or resolve with the treatment of underlying condition. The nurse needs to provide emotional support to the family and impart knowledge to the care provider regarding the treatment choices and resources available. The disease process, common investigations and nursing management of collodion baby are explicated in this article. A case history is briefed with the specific nursing care provided by the community health nurse at the primary healthcare setting.
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Care of patient with desmoid tumour p. 131
Ida Nirmal, Latha Madan
DOI:10.4103/IJCN.IJCN_39_20  
Desmoid tumours are uncommon mesenchymal neoplasms with a fibrotic band-like consistency. They are also called aggressive fibromatosis tumours which are locally aggressive with no potential for distant metastases. The important causes of morbidity and mortality are local recurrence and adjacent organ involvement. Desmoids can be of three types, namely intra-abdominal, in the abdominal wall, or extra-abdominal. Treatment options include observation, surgical resection, radiotherapy, conventional chemotherapy, hormonal agents and newer molecular-targeted agents. A multidisciplinary approach tailored to the individual patient is usually needed, depending on the location, local effects and the clinical course of the disease.
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Adrenocorticotropic hormone-secreting pituitary macroadenoma: A pictorial case report and review p. 137
Ujjwala Murkute
DOI:10.4103/ijcn.ijcn_138_20  
Pituitary adenomas are the most common type of pituitary disorder. While prolactinoma and non-functioning pituitary adenomas are the most common pituitary tumour, adrenocorticotropic hormone (ACTH)-secreting tumours are relatively rare. ACTH-secreting tumour arises from corticotroph cells from pituitary gland and generally presents as Cushing's disease. Thirty-one years old female with recent history of multiple admission to acute care hospital got admitted to general medicine ward with complaints of gastro intestinal disturbance. Magnetic resonance imaging and lab studies confirmed the diagnosis of ACTH-secreting pituitary macroadenoma with development of Cushing's disease. The onset of illness was very slow and most of the signs and symptoms remained non-specific until patient developed severe metabolic and hormonal disturbances. Over a period of two years patient had multiple diagnosis like poly cystic ovarian disease, diabetes mellitus, depression and hyperacidity by different medical practitioners and received symptomatic treatment. Patient's condition completely improved after transnasal endoscopic excision of pituitary macroadenoma normalising her hormonal levels with disappearances of bodily changes. Most of her complications were successfully treated except diabetes insipidus which was identified during pre-operative period remained unchanged even after the surgery and patient continued treatment for the same. In this paper the condition of pituitary macroadenoma and the nursing care of the patient with pituitary macroadenoma is elaborated.
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RESEARCH SERIES NO. 24 Top

Mixed-methods research: Why, when and how to use p. 143
Dorothy Lall
DOI:10.4103/ijcn.ijcn_107_21  
Mixed-methods research emerged in the late 1970s as a methodological approach that uses both quantitative and qualitative data collection methods in one single study. In this article, I present an overview of what mixed-methods research is and identify its defining features. Key considerations in designing mixed-methods research are priority, sequence, stage of integration and use of theory. Each of these is discussed briefly with pointers that could serve as a starting point in designing a mixed-methods research. There is a brief description of the core mixed-methods research designs, namely convergent, exploratory sequential and explanatory sequential, with some examples relevant to the Indian context. Finally, I present some challenges commonly faced in conducting mixed-methods research.
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CONTINUING EDUCATION SERIES NO: 41 Top

Adolescence: An overview of health problems p. 148
Esther Kanthi, Mary Anbarasi Johnson
DOI:10.4103/ijcn.ijcn_110_21  
Adolescents are individuals in the age group of 10–19 years. There are about 1.2 billion adolescents worldwide of which 356 million live in India. Adolescence is a period of transition from childhood to adulthood and involves development and growth in multiple organ systems. MRI studies have revealed that the prefrontal cortex that is responsible for reasoning, regions that process motivation and support higher levels of integration is still maturing during adolescence, and the regions that support emotional and social processing continue to develop even beyond 30 years of age. It is also a time when behaviours that affect present and future health begin. This article reviews the major adolescent physical health problems such as obesity, nutritional deficiencies, pubertal disorders, teen pregnancy, sexual abuse and road traffic accidents and highlights the nursing care of these health problems.
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ORIGINAL ARTICLES Top

Knowledge of skincare and quality of life of cancer patients receiving radiation therapy p. 164
Seema Shankarsingh Chavan, Bismin Sebastian, Blessy Mariya Binu, Caroline Maria Saldanha, Cheryl Charles Viegas, Chinnu Anish
DOI:10.4103/IJCN.IJCN_72_20  
Cancer is a disease in which cells proliferate abnormally. Approximately 60% of patients with cancer receive radiation therapy as a part of their treatment. Projections show that cancer cases in India (2010–2020) are likely to go up from 979,786 cases within the year 2010 to 1,148,757 cases in the year 2020. The study aimed to assess the knowledge of skincare and quality of life (QOL) of cancer patients receiving radiation therapy. The study adopted a cross-sectional descriptive design amongst 123 cancer patients recruited by simple random technique. Knowledge questionnaire assessing skincare and WHOQOL-BREF scales were used to collect data. An informational pamphlet on skincare for cancer patients receiving radiation therapy was distributed after the study completion. Majority of the patients (31.7%) belonged to the age group of 46–55 years and 29.3% were with a primary level of education. Amongst the participated patients, most (43.1%) had received radiation therapy for <11 days, 61.8% used Ayurveda treatment and 48.8% were diagnosed with gastrointestinal cancers. Most (48.0%) received radiation on the head and neck and more than half of the patients (58.5%) were taking chemotherapy along with radiation therapy. The study also found that 55.28% of patients had a good level of knowledge and 52.84% had satisfactory level of QOL. The study concluded that over half the proportion of the cancer patients receiving radiation therapy had some knowledge on skincare and had satisfactory QOL. Thus, we strongly recommend strategies towards the development and implementation of interventions for skincare to improve the QOL.
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Effectiveness of virtual learning module on knowledge and attitude regarding standard days method among public health workers Highly accessed article p. 168
Rajarajeswari Kuppuswamy, Dev Narayan, Jayanti Tiwari, Himani Koulash, Amandeep Kaur, Indra Gehlot, Jigmet Lamo, Deeksha Saini, Ankita Grewal, Chhewang Dolma, Deepika Meena
DOI:10.4103/IJCN.IJCN_70_20  
Standard Days Method (SDM) is an effective, inexpensive, natural, affordable, non-hormonal and modern family planning method that is easy to teach and use. The aim of this study was to assess the knowledge and attitude about SDM and preference of CycleBeads over CycleBead mobile application amongst accredited social health activist (ASHA) as a public health worker. A mixed-method study was conducted on 140 ASHA workers, allocated into two groups of 70 members each in experimental and control group. A simple random sampling technique was used for quantitative strand and purposive sampling for qualitative strand. A self-structured knowledge questionnaire, attitude scale and focus group discussion were used for data collection. Self-developed virtual learning module (VLM) on SDM with CycleBeads was used as an intervention. In the experimental group, there was a significant difference between pre-existing (5.74 ± 2.05) and post-test (14.64 ± 2.25) knowledge score, whereas the difference between the mean of pre-test (4.32 ± 0.67) and post-test (4.68 ± 0.46) attitude scores was not significant. There was no statistically significant difference in the knowledge and attitude scores in the control group. In the qualitative interview, participants expressed their preference for CycleBeads over CycleBead mobile application to teach women about SDM. VLM is useful in improving the knowledge regarding SDM of ASHAs as a public health worker. Public health workers (ASHA) preferred teaching SDM with CycleBeads in person instead of a mobile application for educating the beneficiaries.
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Prevalence and risk factors of non-communicable disease and healthcare-seeking behaviour amongst the adults residing in a selected Village, Mao, Manipur p. 174
Mosozuni Poftte, Adhikari Uma Rani
DOI:10.4103/ijcn.ijcn_132_20  
Non-communicable diseases (NCDs) are increasingly becoming the leading cause of morbidity and mortality worldwide. The objectives of the study were to identify the prevalence of NCDs, risk factors of NCDs and healthcare-seeking behaviour of the persons suffering from NCDs. Two hundred adults were selected by non-probability purposive sampling technique. After assessing the prevalence of NCDs through a structured questionnaire, healthcare-seeking behaviour was assessed for those adults suffering from NCDs. The tools were pre-tested and validated before data collection. The findings of the study revealed that 14.50% (95% confidence interval: 9.5–19.5) of the adults were suffering from NCDs. The most important risk factor, hypertension, was highly prevalent (56.5%). The study findings revealed a high prevalence of behavioural and clinical risk factors of NCDs. This study also revealed that only family history of NCDs was significantly associated with the occurrence of NCDs. In this study, 61.9% of the adults suffering from a NCD sought healthcare, and amongst them, 90.5% availed treatment from allopathy. Intervention programmes and creating community awareness are needed to modify risk factors.
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Utilisation of evidence-based practice and its associated factors among nurses p. 180
Abebaw Alemayehu, Prabhu Chandrashekhar Jevoor
DOI:10.4103/ijcn.ijcn_101_20  
Evidence-based practice (EBP) is a problem-solving approach to clinical practice where, nurses integrate current best research evidence with their clinical skill and knowledge to make decisions for a specific client by considering his/her values. Despite the positive effects on patient care, nurses do not consistently utilise EBP in the clinical areas. The present study was aimed to assess the utilisation and associated factors of EBP among Nurses working in South Nations Nationalities and Peoples of Ethiopia Region Referral Hospitals, South Ethiopia. An institution-based cross-sectional study was conducted from July to September 2019; 684 respondents were selected using the simple random sampling technique, and out of them, 671 had completed the questionnaire making it 98% of response rate. Good EBP utilisation was found among 369 (55%) (95% confidence interval: 51.2, 58.9) participants. Marital status, knowledge, communication skill, training, Internet access, guideline availability and staff culture were the significant predictors for utilising evidence in practice. Although more than half of the respondents had utilised EBP, it was found to be not adequate. Availing EBP guidelines, Internet access and building nurse's EBP competencies, either by giving separate training or incorporating EBP as part of nursing curriculum would improve its utilisation.
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Cartoon based information booklet versus traditional teaching for better outcome in oral hygiene among primary school students p. 188
Mousumi Bhattacharjee, Kasturi Mandal
DOI:10.4103/ijcn.ijcn_103_20  
Dental caries and periodontal diseases have been considered the most important global oral health burdens. Dental caries is still a major oral health problem in both developing and developed countries, affecting 60%–90% of school children and majority of adults. The traditional teaching method is one of the oldest and most common methods of teaching. Innovative methods of teaching are needed for better uptake of information and behavior change. The objective of this study was to compare the effect of cartoon-based information booklet versus traditional teaching regarding oral hygiene on knowledge and practice among primary school students. The quasi-experimental study included a total of 46 Class IV primary school students from two different primary schools. Two schools were randomly assigned as experimental and control groups, the experimental group students had cartoon-based booklet and the control group had traditional method of teaching regarding oral hygiene practices. Structured interview schedule and observational checklist were used to collect the data. The result showed that knowledge and practice of oral hygiene improved after both teaching programme i.e., cartoon-based information booklet and traditional teaching as evident by paired “t” value for knowledge, and also paired “t” value for practice, but when both teaching methods were compared, it was found that cartoon based information booklet was more effective in bringing better outcome in knowledge and practice of oral hygiene compared to the traditional method of teaching. Cartoon-based booklets can be an effective educational tool to improve knowledge and behavior in primary school children.
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Transitional care program for enhancing competence of primary care givers in home care management of neonatal intensive care unit graduates p. 193
Mumtaj Gangihal, K Kavitha, Satish Rathod, Laxmi Pujari, Laxmi Swami, Amar Pyati, Basheerahamed J Sikandar
DOI:10.4103/ijcn.ijcn_108_20  
The discharge of a newborn who had been admitted in neonatal intensive care unit (NICU) for weeks or months after birth is both joy and worry for parents. A comprehensive plan is needed to prepare the parents so that they can take care of their baby by their own after discharge from NICU. The objective of the study was to assess the effectiveness of transitional care programmes on the competence of primary caregivers in home care management of NICU graduates. A Quasi-experimental design with a quantitative approach was adopted. The sample consisted of 80 primary caregivers selected by purposive sampling technique. Data were collected using the demographic profile, structured knowledge questionnaire and observation checklist. The findings showed that the mean knowledge score of mothers regarding home care of NICU graduates improved from 12.8 ± 3.93 in pretest to 27.55 ± 1.93 after the transitional care programme. There was a significant difference between pretest and posttest knowledge of mothers in the experimental group (P < 0.001). The mean knowledge score of caregivers regarding homecare of NICU graduates improved from 12.7 ± 2.47 to 25.6 ± 3.25 after the transitional care programme. However, no significant difference was observed between the study participants of experimental and control groups (P > 0.05). A randomised control trial with a large sample size is needed to find out the impact of transitional care programmes. This intervention can be incorporated into the discharge plan of NICU graduates to minimise the readmission to the hospital.
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Effectiveness of structured pre operative education on anxiety level of patients undergoing elective orthopaedic surgery p. 200
T Jeni Christal Vimala, Rajesh Martin, Anbu Suresh Rao, Melvin Joy
DOI:10.4103/ijcn.ijcn_110_20  
The prevention of anxiety is of prime importance for patients undergoing surgeries. This experimental study was designed to find out the effectiveness of preoperative education on anxiety of patients undergoing orthopaedic surgeries. In this study, 46 patients who fulfilled the inclusion criteria were recruited and randomly allocated to experimental and control groups. On the previous day of surgery, the demographic and clinical data were collected with a specially designed pro forma, the pre- and post-operative anxiety level was assessed by using the state-trait anxiety inventory form Y-1 questionnaire and factors influencing anxiety were assessed by a self-developed questionnaire. The mean change in the level of anxiety from pre-operative to the post-operative period in the control group was 8.10 (standard deviation [SD] = 11.12). Whereas in the experimental group this was 9.08 (SD = 15.28). The difference in change of anxiety level from control to experimental group is −0.98 (95% confidence interval:-8.94, 6.98), which is not statistically significant (P = 0.805). There is no significant association between the level of anxiety and demographic variables. The fear about post-operative pain was the factor experienced by most of the patients (78.3%) both in the control and experimental group to cause anxiety. The study concluded that almost all the patients had one or more reasons for anxiety in the pre-operative period. Both control and experimental groups had reduction in anxiety level from pre-intervention to post-intervention. However, the difference in mean anxiety scores was not significant between control and experimental group. Most of the patients in both groups gave positive feedback on teaching, which made them feel at ease and was helpful in overcoming anxiety. The structured education did not produce any unique impact on the post-operative anxiety in patients undergoing orthopaedic surgery. Other factors related to perioperative anxiety warrants exploration.
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A qualitative study on experiences of women undergoing treatment to achieve fertility from selected infertility centres of Maharashtra p. 207
Supriya Pottal Ray, Nilima R Bhore
DOI:10.4103/ijcn.ijcn_111_20  
Infertility has an immense effect on the roles and relationships in a woman's life. A woman may react differently to issue of infertility as many social customs and traditions are related to pregnancy, childbirth and child-rearing. One is bound to compare another woman on issues of the time of marriage, time gone by after marriage, and successfully becoming pregnant. These issues may not be important to the ones who have conceived but can be traumatic for the one who cannot. Therefore, a qualitative study was undertaken to explore various kinds of experiences women underwent while seeking treatment for infertility. A qualitative hermeneutic phenomenological approach was used for the present study. The saturation of the data was achieved with 48 participants selected purposively from among women who were seeking treatment for infertility in three cities. Individual in-depth interviews were conducted and field notes were taken during interviews. Thematic analysis was done for determining essential codes, themes and subthemes. The themes which emerged from the study were burden about their fertility state, decision-related seeking treatment, commitment to treatment, feeling of inadequacy, support, stigma, hopes and beliefs and coping. The study has revealed that the failure to have a child is distressing to the women; however, there is variation in their reactions to infertility. Qualitative study has provided a detail description of the phenomenon of interest, the human variation and has explained its occurrences from individual viewpoint irrespective of their demographics. The findings will help in counselling services and help nurses to identify and rectify the problems posed by these clients.
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Review of studies on stress, job satisfaction and resilience among nursing professionals p. 215
Shikha Sharma, Parvaiz Talib, Ganesh Singh
DOI:10.4103/ijcn.ijcn_16_21  
Nursing profession is quite stressful. Numerous studies had been carried out to identify the stress, job satisfaction and resilience among nursing professional. The aim of this study is to collate the available literature on the relationship among role stress, job satisfaction and resilience among nursing professionals. Electronic databases (CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles and Proquest) were searched using the various combinations of keywords: nursing stress, nurse resilience and job satisfaction. In addition to electronic databases, manual searches were also undertaken in various nursing journals including the Journal of Advanced Nursing, the International Journal of Nursing Practice and the International Journal of Nursing Studies. A total of eight descriptive and descriptive-correlational studies published in English were included, and data are presented in a narrative summary. The findings revealed a negative relationship between nursing stress and job satisfaction and reported a mediating role of resilience in the relationship. The degree of role stress, resilience level and job satisfaction varied among different demographics and work settings. Workload and staffing inadequacy were reported as the major stressors for nursing professionals. A high level of job satisfaction was attributed to the presence of intrinsic and extrinsic rewards in the profession and the resilient nature of nursing professionals played a pivotal role in managing the level of stress and increases the level of satisfaction among them. Within the limitations of the study such as the lack of literature including all three constructs of the study and methodological constraints of multiplicity of instruments, it was noted that nursing professionals are often stressed due to heavy workload and demanding work conditions, express job dissatisfaction, they try to adjust to the conditions by being resilient. This imposes a persistent need for the health-care system to strategize and ensure the management of workload, sufficient staffing and adequate training for nursing professionals to ensure the delivery of quality health care. A very limited number of studies have examined the role of resilience in the relationship between role stress and job satisfaction. Furthermore, no studies in the Asian context have previously been conducted.
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Predictors of emotional and behavioural problems amongst children of North East India: A hospital-based study p. 221
Amina Ahmed, Arunjyoti Baruah, Nurnahar Ahmed
DOI:10.4103/ijcn.ijcn_42_21  
Mental health problems in early childhood have negative consequences in later life, and risk factors put an extra burden on their health outcome. Hence, researchers aimed to determine the predictors of emotional and behavioural problems amongst the children. A quantitative approach and cross-sectional descriptive design was used to conduct this study amongst 100 parents of children who attended a Tertiary Mental Healthcare Institute of North East India. Participants were selected by using systematic random sampling technique. Data were collected by using Socio Demographic Proforma, Alabama Parenting Questionnaire and Strengths and Difficulties Questionnaire. Data were analyzed by using stepwise multiple linear regression techniques to determine predictors of emotional and behavioural problems amongst the children. Findings revealed that age of the child and inconsistent discipline are the significant predictors of the emotional problems, poor monitoring/supervision is the significant predictor of conduct problems, age of the child, poor monitoring/supervision and inconsistent discipline are significant predictors of hyperactivity; gender of the child is the significant predictor of peer problems and poor monitoring/supervision and corporal punishment are the significant predictors of the total difficulties. Findings also revealed that positive involvement is the significant predictor of pro-social behaviour. These findings confirmed that negative parenting practices, age and gender of the child are the risk factors for the emotional and behavioural problems amongst the children. Therefore, health professionals working with children need to consider these factors in planning a comprehensive intervention package for better outcome.
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STUDENT SECTION Top

Knowledge and practices towards occupational health and safety management strategies among sculptors p. 227
T Asher, M Shobana, A Aamina, A Abarna, B Bharathi, Ponnambily Chandy Jobin
DOI:10.4103/IJCN.IJCN_74_20  
Reports of occupation-related accidents are on the increase in India despite the enforcement of the National Occupational Safety and Legislation Act 2020. On the other side, many accidents go unreported. It is time to shift the focus of the research towards the small-scale industries to monitor the occupational environment to protect the minority group as a large workforce. This study was conducted to assess the knowledge and practices towards occupational health and safety management strategies among sculptors in selected sculpture sites of selected villages in Kanchipuram district. A descriptive research design was used. A total of 50 sculptors from four sculpture sites were included in this study. Results showed that the majority of the study participants were illiterate, between 20 and 35 years of age, males and alcohol consumers, had a moderate level of knowledge on occupational health and were exhibiting a moderate level of practice towards occupational safety. It is also reported that there was a lack of basic facilities for the workers in the work environment. Importance of having frequent monitoring and inspection of worksites to keep the workforce safe from adverse health outcomes are suggested.
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EVIDENCE BASED GUIDELINES Top

Evidence Based Guidelines p. 231

DOI:10.4103/2230-7354.336902  
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