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   Table of Contents - Current issue
January-June 2022
Volume 23 | Issue 1
Page Nos. 1-109

Online since Tuesday, July 5, 2022

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Post-pandemic changes and challenges in health care p. 1
Vinitha Ravindran
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When in doubt, cite! do nursing students care to cite? A nurse educator's perspective on plagiarism Highly accessed article p. 3
Mini George
Plagiarism is an age old problem that has plagued the academic landscape. This problem has gone unabated in educational institutions across disciplines. Nursing Education in India is no exception. Many nursing students are unclear as to what amounts to plagiarism or that cheating has consequences. Nurse educators can play an important part and need to feel strongly about academic integrity and not ignore cheating. Creating awareness about academic writing and teaching students to cite, starting from their inception into the program and reinforcing this behavior regularly is an essential component to curbing. Nursing Educational Institutions have to upscale their strategies to prevent this menace. Finally, crucial to understanding and countering academic dishonesty in the classroom and clinical settings; and finding innovative strategies including the role of nurse educators, is to conduct high quality researches
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Nurture intervention on neurodevelopmental outcome among pre-term neonates: Application of child health assessment interaction model in nursing research p. 6
Monica Rita Hendricks
With scientific advances, the survival rate of pre-term babies has increased from 50% to 85%, but the quality of life, morbidity status and neurodevelopment outcomes still remain questionable. A high-quality mother–infant interaction facilitates the child's socio-emotional, behavioural, cognitive and physical development. Fostering nurture-maternal touch, eye-to-eye contact, vocal soothing, odour exchange and Kangaroo Mother Care, to those born too soon and are within neonatal intensive care unit (NICU) constraints forms the background of the research. This article demonstrates how Kathryn E Barnard's Child health assessment interaction model is applied to a nursing research that aims at understanding the effect of nurture on neurodevelopmental outcomes of pre-term neonates admitted to the NICU of a tertiary care hospital. The four main concepts of the model are discussed in terms of interdependency on each other. The theory also brings to the forefront the influence of each component on the outcome.
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HELLP syndrome in pregnancy p. 12
Zuchanbeni Humtsoe
HELLP is an acronym that refers to a syndrome characterised by haemolysis, elevated liver enzymes and a low platelet (HELLP) count. It is a rare and life-threatening condition that occurs during pregnancy. The most common symptoms of HELLP syndrome include headache, nausea, vomiting, upper right abdominal pain, tenderness and fatigue. Most symptoms and side effects subside within 2–3 days of delivery. Early identification and treatment is essential to prevent complications of HELLP syndrome.
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Care of patient with mucormycosis p. 18
Glory Paul, Veda Leena, Manjula , Praveena
Mucormycosis is the second-most frequent mould infection in immunocompromised patients and can progress rapidly. Early diagnosis, surgical debridement, systemic antifungal therapy and control of underlying conditions are the key elements in the successful management of this infection.
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Re-orientation and simple understanding of regression analysis for student nurses: When and why to use p. 24
Anindita Mandal, Suresh K Sharma
With the advancement in science and technology along with growing demand for emergency medical care, estimation of some unknown factors of interest has become vital in biomedical science and healthcare. Prediction based on a known variable could be applied in making decisions, correcting an error, preventing any risk, or for some achievement. It can be an estimation of needed items and devices; recovery time of a patient, profit or loss of the organization, etc. One of the requiring statistics for this purpose is regression analysis which can identify the influence of one variable on another and calculate the unknown prediction from a familiar one. A present narrative review on regression analysis has been structured by reviewing E-literature, textbooks, unpublished information and practical experience of authors. This article would be useful to the researchers to be updated with more practical information and a needful application of the same.
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Psychological issues in adolescents p. 29
Ruma Nayak, Margaret Manoharan, Lilly Prasad, Santhi Gladston, Menaka Raghuram, Deena Edwin, Esther Kanthi
Adolescence is a critical period of development in a young person's life, marked by important biological, cognitive, emotional and social changes. It is also a period when adolescents become autonomous and independent and try to develop an identity for themselves. This phase involves many psychological challenges and issues. This article reviews the major psychosocial problems during adolescence.
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Concept mapping: A learning strategy p. 40
Betty Koshy, Aarohi Fernandes
Concept mapping (CM) is an innovative educational strategy that promotes meaningful learning. This study aims to evaluate the effectiveness of structured teaching programme regarding the use of CM as a learning strategy on knowledge, psychiatric care plan presentation and satisfaction among B.Sc nursing 3rd-year students of selected nursing colleges in Raipur, Chhattisgarh. A pre-experimental (one group pre-test and post-test), evaluative research approach was used to achieve the objectives of the study on 60 B.Sc nursing 3rd-year students using a purposive sampling method. The findings revealed that 60 (100%) of them improved on the pre-test scores in terms of their conceptual understanding in the post-test with a mean score of 8.9 (standard deviation [SD] = 1.2) with 't' = 35.15 which is highly significant at 0.00001 level. The assessment of satisfaction regarding CM revealed that 60 (100%) students were highly satisfied with CM as a learning strategy with a mean score of 54.4 (SD = 3.6) and 't' = 27.68 which is highly significant at the 0.00001 level. The coefficient of correlation between post-test knowledge and satisfaction scores was found to be r = −0.01 at P > 0.05 (P = 0.93). The coefficient of correlation between post-test psychiatric care plan and satisfaction scores was found to be 0.4 at P < 0.05 (P = 0.001).
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Analysis of academic performance, study behaviour and factors influencing study behaviour among nursing students p. 44
Shany Thomas, Ankur Mahida
Every student is distinctive and uniquely learns things. There are numerous factors, which may encourage or hamper the students' learning style and intellectual performance. These factors must be addressed with due significance to ease learning. The study is designed to look at the academic performance, study behaviour and factors influencing study behaviour among nursing students. A cross-sectional survey was carried out among 223 basic BSc nursing students. Instruments used for data collection were demographic pro forma, checklist on factors influencing study behaviour, study behaviour inventory by Bliss and University result sheet. Academic performance revealed that 52.9% of students scored between 70% and 79.9% regarded as first class. Majority (70.9%) of the participants demonstrated a moderate level of study behaviour (mean-107.3, standard deviation-13.3). Learning environment, personal factors, interest, attention, learning behaviour, language, home-related factors and time management were the extracted components influencing study behaviour. Among the factors, 'absenteeism', 'getting disturbed by siblings/friends during study hours', 'feeling to take time off from college frequently' and 'doing assignments regularly' were significantly associated with study behaviour. Ability to make lecture notes (χ2-12.39, Sig.− 0.05, P < 0.05), utilisation of learning facilities (χ2-9.35, Significance − 0.025, P < 0.05) and satisfaction with learning facilities provided (χ2-13.62, Significance − 0.034, P < 0.05) were significantly associated with academic performance. The findings of the study exposed some of the factors, as perceived by the students, influencing the study behaviour and academic performance. Understanding these factors will help the faculty to come up with a strategy to enhance the students' overall performance.
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Effectiveness of awareness programme regarding breastfeeding techniques on the prevention of nipple soreness amongst primipara mothers in a selected hospital at Mangaluru, Karnataka p. 49
Sangeetha Crasta, Pramila D'Souza, Reena Wilma Frank
Breastfeeding is a crucial and unrivalled way of providing ideal food for the healthy growth and development of infants. Exclusive breastfeeding in the 6 months of life plays a pivotal role in child health. Faulty technique of latching causes nipple soreness or trauma. The WHO estimated that 33% of all women experienced breastfeeding problems in the first 2 weeks of post-partum. This study aimed to determine the effectiveness of awareness programme regarding breastfeeding techniques on the prevention of nipple soreness amongst primipara mothers. A non-equivalent, post-test only control group design was adopted on 60 primipara mothers who were selected using the purposive sampling technique. Awareness programme regarding breastfeeding techniques was given to the intervention group. A demographic pro forma and Nipple Soreness Rating Scale were used to collect the data. In the intervention group, the post-test nipple soreness mean score was 0.2, and in the control group, the post-test nipple soreness mean score was 2.2, and the mean difference was statistically significant. The calculated Mann–Whitney U-test P = 0.001 showed that there was a statistically significant difference in mean post-test nipple soreness scores between the intervention and control groups. There was no significant association between the mean post-test nipple soreness score and demographic variables in both intervention and control groups. The awareness programme regarding breastfeeding technique was effective in the prevention of nipple soreness amongst primipara mothers.
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Effectiveness of muscle energy technique versus positional release therapy on range of motion and pain in non-specific low back pain p. 54
Priya Chauhan, Kapil Khare, Khushboo Vachchani, Gaurav Kapoor
Low back ache is the largest cause of sick leave, and half of the population will have experienced a significant incident of low back ache by the age of 30. In India, low back ache prevalence has been reported to be around 23.09%. Severe pain in the lower back is sequel of numerous causes, such as faulty posture, muscular dysfunction (e.g.: muscular imbalance and short or weak muscle), overuse, instability and articular dysfunction in the low back, accident or trauma and most commonly road vehicle accidents. In 85%–90% of cases of lower back ache are non-specific in nature. The function and co-ordination of the muscles that stabilise the lumbar spine, especially the back extensor muscles are often impaired in patients with low back pain. Erector spinae strain and fatigue is one of the causes of back pain. A total of 30 subjects with acute low back pain participated in this study. Group A were treated with hot moist pack and muscle energy technique (MET), whereas Group B were treated with hot moist pack and positional release therapy (PRT). Both the groups received a conventional training protocol for 3 days a week for 4 weeks. The result from these tables shows changes in both the groups, with statistically significant changes were noticed in Group B. The present study showed that both PRT and MET within hot moist packs could be of benefit in the treatment of acute low back pain associated erector spinae muscle spasm. There was significant difference in the intensity of pain within the groups and between the groups after 4 weeks of treatment. Reduction in pain intensity was significant in the PRT group. Pain relief was achieved with both Group A and Group B, but was appreciably more significant in the PRT group. There is a significant difference between both Groups A and B. Hence, PRT is more effective than MET.
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Effectiveness of quality-of-life counselling with hatha yoga among human immunodeficiency virus-infected adolescents: Randomised control trial p. 59
Rajathi Sakthivel, Shankar Shanmugam Rajendran
Adolescents are high risk and underserved group in the international and national response to acquired human immunodeficiency virus (HIV) epidemics. Children with HIV infection may experience more difficulties in their daily life because of parental death from acquired immunodeficiency syndrome and social stigmatisation may worsen their quality of life (QOL). The therapeutic practice of Hatha Yoga and QOL counselling promotes healthy practices, develops positive attitudes and enhances well-being of adolescents living with HIV (ALHIV). The aim of this study was to evaluate the effectiveness of QOL counselling with Hatha Yoga in HIV-infected adolescents. A randomised control trial design was adopted for the study. A total of 388 HIV-infected adolescents were randomised into experimental (195) and control groups (193) by the simple random technique. Data were collected from HIV-infected adolescents/caregivers from four main antiretroviral therapy Centres in Chennai, India, through Health Related QOL Assessment Questionnaire. QOL counselling was provided only to the experimental group and Asanas were demonstrated by the researcher. At the end of data collection, cursory instructions regarding QOL counselling and yoga were also given to the control group. Data were collected from both groups in 3-month intervals from the time of allotment ('0', 3rd and 6th months). . In both groups, mean QOL score in pre- and post-test score was 163.6 versus162.9 at '0' month and 215.6 versus166.0 at '6' month, respectively. The mean difference in QOL gain score was 51.97 in the experimental and only 3.09 in control group. There were significant changes in QOL score in the experimental group. The factors such as age and gender of ALHIV and caregiver's age, gender, relationship with adolescents and residence are significantly associated with increased QOL. The motivational QOL counselling along with yoga has effectiveness to increase QOL among HIV-infected adolescents in the experimental group.
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Perception of Indian nursing students about e-learning during COVID-19 pandemic: A cross-sectional study p. 67
Shelly Dhawan, Mahendra Kumar, Binal Joshi, Ankita Singh
COVID-19 pandemic led to abrupt disruption in the routine functioning of nursing education, which resulted in a sudden transition from on-campus face-to-face learning to e-learning approaches. The fast advancement of science and technology insists educational institutions think about different ways of teaching and learning in both formal and informal environments. The purpose of this study was to investigate the nursing student's perceptions regarding e-learning. This cross-sectional study was conducted by using non-probability sampling technique. Data from 835 graduate and post-graduate nursing students across the nation were collected through 20 items web-based questionnaire to sort information regarding their perception towards benefits and limitations of e-learning, challenges encountered and required modifications in teaching–learning techniques through online platform. Findings of this study suggested that nursing students find e-learning beneficial in terms of saving time to travel and their ability to communicate. Students perceived this technique limited as far as problem-solving techniques, clinical skills, teamwork etc., are concerned. In this study, 42.4% and 38.9% of students agreed and strongly agreed respectively that utilisation of excessive data and connectivity is one of the encountered challenges while learning through e-platforms. 64.6% of students stated their preference to learn some part of the syllabus through online mode even after pandemic. A well-planned e-learning method can deliver numerous benefits but student retention in virtual/e-learning can be a barrier to the growth of technology depended teaching–learning. The future of nursing education should include a combination of technology-based and traditional learning.
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Prevalence of oral problems among patients with Type II Diabetes Mellitus in the Selected Urban Area of Vellore City, Tamil Nadu p. 76
Irene Dorathy, Rajeshwari Siva, Rabin Chacko, Tunny Sebastian
There is a rapid increase in diabetes mellitus worldwide causing premature deaths (1.6 million deaths in 2016) due to complications of the disease. India is said to have a greater number of diabetics, and diabetes remains one of the leading causes of death due to complications in India. Poor glycaemic control in patients not only affects their heart, kidneys, eyes and nerves but also affects the oral cavity. Periodontal disease is considered the sixth complication of diabetes mellitus, and it is seldom addressed. This study was conducted to assess the extent of oral problems amongst the clients with Type II diabetes mellitus in the selected urban area of Vellore district. A total of 150 samples were selected using simple random technique method. Informed consent was obtained from every subject, and the study was approved by the institutional review board. Data were collected using a structured pro forma, and a thorough oral examination was done to identify oral problems. The data were analysed using SPSS and were presented with explanatory statements in tables and graphs. The study findings revealed that the prevalence of periodontitis was high (64.7%) amongst the Type II diabetes mellitus and half of the subjects (53%) had one or the other oral problems such as calculus, stains dental caries, bleeding or swollen gum, gum recession and loose tooth or missing tooth. Regular dental check-up is mandatory for all diabetics, and oral health education is much required for better glycaemic control which will help to reduce the mortality rate and country's burden.
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Effectiveness of salbutamol administered through a metered-dose inhaler with nebuliser amongst children for acute asthma treatment p. 81
Deena Edwin, Sneha Deena Varkki, Bobby Violet, Hari Prathap Reddy, Vinitha Ravindran, Ruma Nayak
Administration of salbutamol by metered-dose inhaler (MDI) with spacer is as effective as nebuliser in terms of clinical response and patient outcome. In addition, fewer side effects and lesser hospital admission rates are recorded with this method. Changing the practice of using nebuliser to MDI with spacer as the preferred mode of treatment for mild-to-moderate asthma has been studied. In this study, 68 children between the age groups of 5 and 18 years with mild-to-moderate severity of asthma admitted in the paediatric emergency service and the child health outpatient department were studied to compare the effect of salbutamol delivered via MDI with salbutamol through nebuliser for acute asthma treatment. In this study, 70 children with asthma were randomly allocated to the MDI and nebuliser groups. The standardised Modified Pulmonary Index Score was assessed by the clinical assessor before and 10 min after the intervention. The findings revealed that the clinical outcome was highly significant in both the groups. However, the feasibility of using MDI with spacer in comparison to nebuliser was found to be highly significant in relation to the effectiveness, utilisation of hospital resources (treatment preparation, delivery time and cost) and acceptability to patients. Results of the study carried out in the paediatric population indicate that MDI with spacer is as effective as nebuliser in the treatment of children with mild and moderate acute asthma exacerbations in the hospital setting. However, MDI with spacer has more additional benefits such as fewer side effects, less time consumed to administer the treatment, cost-effective, portable and easier to use than nebulisers.
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Impact of a capacity-building initiative for first-year student nurses on reproductive and sexual health: A quasi-experimental study in Bangalore city, Karnataka, India p. 86
Sharon Hartley, Jennifer Tavares, Mercy Pushparaj, Sumithra Selvam, Prem Mony, Maryann Washington
There is evidence of gaps in knowledge, perception and self-assessed competence on reproductive and sexual health (RSH) issues of nursing students. A quasi-experimental study was conducted in Bangalore city between January 2017–December 2018 to study the impact of a capacity-building initiative for 1st-year nursing students on their knowledge, perceptions, self-assessed competence and resilience. Eight nursing institutions were selected purposively; initially, four were allocated randomly through lottery method to the intervention group (IG) and four to the comparison group (CG). Since one institution dropped out before the intervention from IG, another institution was recruited to replace this institution. Both, the IG and CG, had seven batches of students (three diploma and four degree) each. A sample size of 120 students for each group was required. An investigator-developed and validated survey was administered to both groups at the start (pre-test) and 18 months after the start (post-test) of the study to assess their knowledge, perceptions and self-assessed competencies. Resilience was measured at the end of the study using a standardised tool, 'The Child Youth Resilience Measure'. A capacity-building initiative (31.5 h) which was participatory, contextualised and integrated life skills, was implemented for the IG over a period of 18 months. A condensed version of the programme (13.75 h) was provided to the CG over the same period. The analysis considered a total sample of 625 students (IG = 294; CG = 331) that participated in both, the pre-test and the post-test. Nursing students within both groups showed statistically significant improvement in their overall knowledge scores from pre-test to post-test (P < 0.01). However, the difference in the overall knowledge scores of IG and CG (between groups) was not statistically significant at the post-test (P = 0.076). There was a statistically significant increase in self-assessed competencies on RSH within both groups from pre-test to post-test (P < 0.001), but no statistically significant difference was seen between the two groups at post-test (P > 0.05). There was no significant difference (P > 0.05) in resilience scores between IG and CG at the post-test. The study is limited in that it could not measure competencies in the real-world setting. The study shows that changes in perceptions would require more time and possibly more practice and experience. Nevertheless, even condensed versions of such capacity-building initiatives could improve the overall knowledge and self-assessed competencies of nursing students.
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Engaged or not?: A case study on nurse's engagement in clinical settings in India p. 95
Shruti Bhardwaj
Engagement is a much-debated term relating to its interpretation and direct outcomes. Engagement has a direct link to first-level outcomes such as turnover intention or employee performance. Engagement, in nursing, has also risen as an area of interest to health-care professionals and researchers. Extreme views about the nursing profession, female-centric workforce and different health systems in the nursing profession worldwide make this profession unique. This case study, combined with the grounded theory data analysis technique, aims to explore the nurse engagement practices in clinical settings in India and their impact on the turnover intention of nurses. Face-to-face interviews with nurses providing direct patient care from two tertiary care hospitals in India were conducted for data collection. A total of 17 interviews were analysed using the grounded theory coding mechanism. Five major themes emerged in this study. First, Leadership styles; second, social influence and nursing as a career of choice; third, the philanthropic side of nursing; fourth, generational difference towards nursing and fifth, the unfairness of treatment toward nurses. The study results suggested that there is a lack of engagement models in the Indian health-care delivery system, especially in the public sector. Nurses, while burdened with work, were found to be less valued and undercompensated at work, leading to low engagement and high turnover intention. Different generations of nurses had different views of the nursing profession. This study indicated a need to address nurse engagement according to age groups as the motivation of choosing nursing as a career has changed over the generations, resulting in varying degrees of engagement.
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Menopausal symptoms and coping strategies among menopausal women in selected hospital at Mangaluru p. 102
C Mary Sophia, Josephine Marngar, Soorya Mol, Violet D'Souza, Reena Wilma Frank
Menopause is one of the most significant events in a woman's life and brings several physiological changes that permanently affect women's lives. In India, menopause is considered a normal phenomenon. Women themselves may not seek medical help for their problems associated with ageing. Therefore, the present study was conducted to determine middle-aged women's commonly reported menopausal symptoms and coping strategies. A descriptive survey design was used, and 100 menopausal women aged 45–60 years were selected and interviewed to assess the menopausal symptoms and coping strategies followed to overcome the same. The results showed that 63% of the subjects had moderate symptoms and 30% had severe menopausal symptoms; these were assessed through the menopausal rating scale. The coping strategies show that 54% of women use a cooler environment to face the hot flash and sweating, 55% of women sit in a comfortable place to relieve their heart discomfort, 47% of women have milk in the night to manage the sleeping problems, 60% women use hot water to relieve Joint and muscular discomfort. Hence, there is a need for improvement of menopausal health status and application of various coping methods, including the establishment of social networks, is warranted to enhance menopausal women's behaviours in different aspects.
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Resilience amongst the elderly during the COVID-19 pandemic lockdown p. 106
J Metha, T Priscilla Prema Kumari, P Meenakshi, Rogina J. S Savarimuthu
Many old people live with challenges, poor health and hardship in their life. In spite of the crisis and losses, they tend to experience low impact as compared to the general population, which may be accounted to their resilience. Resilience is achieving the same level of functional ability as such of the pre-crisis state. A study was conducted online to assess resilience amongst the elderly during the COVID-19 pandemic lockdown in a selected rural community area, Chengalpattu district, Tamil Nadu, India. A descriptive research design was used. The sample size was 67. Convenient sampling technique was adopted. The demographic profile and the Connor-Davidson Resilience Scale-25 were used as data collection instruments. Many older people showed moderate levels of resilience, and the mean score was 57.86. Gender and educational status and family income were significantly associated with resilience.
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Evidence Based Guidelines p. 109

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