Madridge Journal of Nursing

ISSN: 2638-1605

3rd International Nursing Conference

Nov 7-9, 2018, Tokyo, Japan
Accepted Abstracts
DOI: 10.18689/2638-1605.a3.005

Nurse Educators Perceptions of Using High-Fidelity Simulation in Teaching

Marline Whigham

Nova Southeastern University, USA

Nurse Educators Perceptions of Using High-Fidelity Simulation in Teaching. High-fidelity simulation in nursing refers to the use of computerized manikins to offer realistic hands-on training to nursing students. The problem addressed by this dissertation was resistance among some faculty to the use of new computerized simulation technology in the nursing curriculum. The research question for this case study investigated how faculty members can incorporate simulation into the curriculum and barriers faced in setting the stage for simulation experiences for their students.

The goal of this applied dissertation study was to examine the perceptions of nurse educators regarding the benefits of and barriers to use of high-fidelity (computerized manikin) simulation with students in a university nursing program. The theoretical underpinnings for the study were concentrated within a constructivist framework.

Biography:
Marline Whigham received her undergraduate degree from Florida Atlantic University, her Graduate Degree from the University of Phoenix and a doctoral degree from Nova Southeastern University. Professor Whigham has worked clinically as an Intensive Care nurse for over 25 years. She was recognized for Nursing Excellence by her peers and has served as a mentor to new graduates. Presently she works as a nurse educator teaching pathophysiology, advanced medical-surgical nursing; the nurse as a leader; trends in nursing, and nursing practicum to baccalaureate nursing students on the Miami regional campus in Ron and Kathy Assaf College of Nursing. She has completed the NSU College of Allied Health and Nursingʼs (CAHN) Teaching and Learning Academy, and the CAHN Leadership and Management Academy, She is quite knowledgeable and well versed in evidenced-based practice as it pertains to clinical nursing. She maintains currency in her field and integrates best practices into her courses and student clinical experiences. Professor Whigham has functioned in the role of nurse educator for nine years at NSU. She serves on several College and University committees, has engaged in research and presented at several local and national conferences. She is a member of Sigma Theta Tau International (STTI), and many national and state nursing professional organizations. She is currently enrolled as a student in Barry Universityʼs Doctor of Philosophy in Nursing program.

A Study to Assess the Health Related Quality of Life of Caregivers and Adolescents with Idiopathic Epilepsy

Judie Arulappan

Sultan Qaboos University, Oman

Introduction: India is home to large numbers of individuals with epilepsy. The annual incidence of epilepsy in India is approximately 40-50 per 100, 000 per year. Epilepsy onset after the age of 10 years is associated with lower HRQOL. Seizure frequency is a significant inverse predictor of HRQL.

Purpose of the paper: The purpose of the study is toassess the health related Quality of life of care givers and adolescents with idiopathic epilepsy and self-reported care givers strain among care givers of adolescents with idiopathic epilepsy.

Methods and procedures: A Quantitative descriptive exploratory survey research design was adopted. The study was carried out in Epicentre, Kauvery hospital, Chennai. 12-19 years oldadolescents with idiopathic epilepsy and their primary care givers were the samples. Purposive sapling technique was used to select274 samples. WHO BREF HRQOL tool was used to assess the quality of life of care givers. The Modified Caregiver Strain Index (MCSI) was used to screen for caregiver strain. Quality of life in epilepsy for adolescents- QOLIE- AD- 48 (Version- 1) was used to assess the quality of life of adolescents. Ethical approval was obtained from the data collection setting. Descriptive and Inferential statistics were used to analyze the data.

Results / Expected Outcomes: Poor health related quality of life of adolescents is seen in general health, physical illness, emotional problems, mental activities in school, work, living practices, language problems and support from friends and family members. Also poor HRQOL was associated with epilepsy medications, side effects of anti-epileptic drugs, feeling about oneself and attitude towards epilepsy. HRQOL was found to be poor in males andfirst born adolescents. Moderate HRQOL is seen married care givers. Poor HRQOL is seen in care givers living in semi urban region, living in nuclear family, having more than two children, having more than 4 family members, care givers with chronic illness, who were unemployed, and having poor economic status.

Conclusion: Adolescent centered epilepsy management programme was initiated on completion of the study to improve the health related quality of life of care givers and adolescents with Idiopatic epilepsy.

Biography:
Judie Arulappan is an assistant professor in the department of Maternal and Child health at Sultan Qaboos University, Oman.

Oral Health Related Quality of Life (OHRQoL) and the Impact Factors for Alzheimerʼs Patients-- A Systematic Review

Yung Ming*, Shou-Jen Lan and Shang-Wei Hsu

Asia University, Taiwan

The objective of this study was to verify the people of Alzheimerʼs disease (AD) had a lower Oral Health Related Quality of Care (OHRQoL) than non-dementia, and whether their OHRQoL was impacted by oral health negatively. A search was carried out on PubMed, Cochrane Library database, Medline, EBSCO, ProQuest, and EMBASE. The keywords were included dementia (Alzheimer, cognitive impairment), oral(dental), prosthesis (implant) and OHRQoL (GOHAI, OHIP). OHRQoL was investigated as the outcome, and tooth loss, periodontal diseases, dental caries and masticatory efficiency(ME) were exposures. Six studies were included. The sample sizes ranged from 30 to 226 subjects; five studies were cross-sectional designs, while one was nonrandomized, single-center, controlled clinical trial. Two OHRQoL instruments were identified, and the most frequent was the GOHAI (Geriatric Oral Health Assessment Index, n = 5). Another was OHIP-14 (Oral Health Impact Profile-14). Three of 6 studies reported a higher OHRQoL scores to compare AD with control groups, just one study was significant(P<.05). One study found the more severe of AD, the lower scores of GOHAI. All of studies mentioned the impact factors of OHRQoL, include 3 of six studies found the severity of cognitive impairment, two showed the poor of oral health condition (periodontitis, Gingival bleeding, probing depth >4mm, and absence of more than 2 molar teeth), and one showed less number of nature teeth. When the patientsʼ cognitive ability was defect, feeling pain and discomfort from the periodontitis, gingival bleeding, missing teeth and decay were reduced, leads to the scores of their OHRQoL may higher than control groups. That was why the patients with AD were thought to require special attention by dental professionals early. And a more holistic approach for the patients of AD, the more completed dental examination may be done regularly complemented by clinical dentists and nurses.

Biography:
Yung Ming is a nurse who had been in nursing work for 30 years and specialized in Emergency, Intensive Care Nursing and Nursing Administration.

Determination of Psychosocial Requirements of Cancer Outpatients and Inpatients in Private Hospital

Elçin BABAOĞLU1* and Havva Gül Ergül2

1Uskudar University, Turkey
2Anadolu Sağlık Merkezi Hospital, Turkey

Cancer is not only a chronic disease but also consists additional diagnosis like psychiatric disorders. The psychiatric consultationliaisonnurse is interest in psychosocial care of the patients and their family. Because of the studies about the determination of psychosocial requirements of patients are limited, in this study psycho social requirements of outpatients and inpatients in privatehospital are investigated aiming to provide the best psycho social carewith evaluating biopsycho social integrity. This study is done in Anadolu Medical Center as a descriptor. The sample of the study consists of 149 patients that receive a treatment between the dates of 01.02.2017 and 01.07.2017 and suit the criterions of the study. As a data collection instrument, socio demographic data form which is consisted of 22 questions about patientsʼ introductory information and determination of psycho social requirements form which is developed by there searcher and be consisted of 57 questions that represent patientsʼ affective domain and social domain are used. Internal reliability analysis, independent samples t-test, One-Way ANOVA, Tukey HSD test and correlation matrices are examined and SPSS 24.0 is used in the evaluation of the data.

According to results of the study; variables which affect the psycho social requirements of cancer outpatients and inpatients are determined as age, gender, marital status, income level, age at diagnosis of the patient and type of cancer. At thesame time, emotional and social problems are detected to mutually influence each other. In the direction of the findings, it is concluded that there are significant differences between emotional and social requirements of cancer outpatients and inpatients and suggestions based on the results are developed.

Employee Empowerment in the Health Sector in Papua New Guinea: A Multilevel (Cross-Level) Study

Peter Maima

Fiji National University, Fiji

Employee empowerment is a valuable management tool used by organizations to improve and enhance performance. Whilst majority of the empowerment literatures concentrate on linear empowerment approach, the emerging multilevel (cross-level) empowerment has hardly gained research attention so far. Hence, this study used a multilevel model to examine employee empowerment in the health sector in Papua New Guinea and its link with perceived service quality. The study has adopted cross-sectional survey of 327 clinicians including nurses in four major hospitals in the country particularly Port Moresby, Kerema and Popondetta Genera Hospitals including Laloki Psychiatric Hospital between April and May, 2018. Multivariate regression and correlation analyses using EViews (statistical tool) show that structural empowerment and empowering leadership have a statistically significant influence on the employeesʼ psychology both at the individual and team (unit) levels, and in turn these have a significant influence on perceived service quality. Additional analysis of 22 dimensions of all five study variables (structural empowerment, empowering leadership, unit empowerment, psychological empowerment, and perceived service quality) indicate a generally weak to moderate empowering leadership practice in leading by example, participative decision-making, coaching, informing, and team interactive with an average of 3.5 on a 5-point rating. Furthermore, structural empowerment reveals that hospital employees have limited access to opportunity, information, support, and resources required to perform their roles with an average of 3.3 on a 5- point rating. Also, a reliable workforce was rated 3.7 whilst the appearance of employees and facilities including performance of equipment/materials rated 3.0 on a 5 point scale. The study outcome suggests implications for improvement by adopting multilevel empowerment frameworks to add value to the existing systems particularly within complex and dynamic hospital systems.

Biography:
Peter is currently a PhD candidate in business and health services interdisciplinary study at Fiji National University. He was formerly the senior manager of radiology department at Popondetta General Hospital, Papua New Guinea. He has 15 years of work experiences in the health sector apart from his role as branch president of allied health workers association for 9 years before pursuing his doctoral career

Development and Feasibility Test of a Novel Evidence-Based and Theory-Based Co-Designed Intervention to Support Saudi Women with Breast Cancer

Alaa Alanazi

Swansea University, UK

Introduction: Breast cancer is the most commonly diagnosed cancer in Saudi women. The cancer and treatment can produce many different psychosocial issues and physical symptoms. Different studies reported a low overall quality of life among Saudi women with breast cancer. There is evidence that self-management support (SMS) interventions delivered by nurses have the potential to help reduce these symptoms and enhance the quality of life. In Saudi Arabia, the provision of SMS is unknown and therefore, this study aims to develop and test the feasibility of an intervention to support Saudi women with breast cancer.

Methodology: This study is guided by Medical Research Council (MRC) framework for developing and evaluating complex interventions which involve a systematic multistage process. Stage one involved an evidence synthesis by conducting a systematic literature review and qualitative in-depth interviews using a purposive sampling with 23 Saudi women newly diagnosed with breast cancer in three hospitals to understand their needs and concerns. Ethical approval and consents were taken and the theoretical saturation of data were achieved. The digitally-recorded data and field notes were transcribed, organized using MAXQDA software and analysed using a thematic analysis. Stage two included developing a self-management programme by applying a theory and evidence to identify effective components to support patients alongside consultations with health care professionals and patients. Stage three will include a training workshop for nurses to ensure fidelity who will implement intervention on patients using a pre-and post-intervention study to evaluate its feasibility, acceptability, and potential impact using mixed method.

Result: The literature and qualitative study showed that those women have physical, psychosocial, practical, and informational needs. The theory of social learning and self-confidence developed by Bandura has been applied and the literature shows that components such as: group-based intervention, education, goal setting, action plans, and navigating health system and resources are effective to support patients successfully. The rest of stages will be conducted soon.

Conclusion: Saudi women with breast cancer experience challenges to manage disease and treatment-related symptoms. It is anticipated that delivering self-management intervention will help to enhance quality of life.

Trauma-Informed Education Toolkit for Screening Pediatric Victims of Sexual Abuse and Maltreatment

Analena Michelle Lunde

Walden University, USA

The complex challenges facing the sexual assault nurse examiners program in a midwest state are under reporting, late reporting, and poor coordination of care for pediatric victims of child maltreatment with sexual abuse. The main objective of this quality improvement project was the identification of necessary practice-related approaches to care to decrease barriers associated with reporting suspicions of abuse or neglect. An evidence-based, multidisciplinary assessment clinical toolkit that followed clinical components of trauma-sensitive, child- centered screenings triggering a coordinated response to conduct a forensic medical exam within 96 hours of the alleged incident was evaluated. During 3 rounds of surveys following the Delphi technique, 10 members of an expert panel agreed upon critical success indicators were used for the review and final decision for adoption of the toolkit. The final consensus obtained, with an intraclass correlation of 0.924 with a 95% confidence interval, supported implementation of this trauma-informed toolkit which would ensure that medical care and throughput through the system of care addressed the physical and mental needs of the patient and caregivers as well as improvement in the forensic investigative data collection. A child- centered, trauma-sensitive approach to screening and evaluation by healthcare professionals will help decrease the delay to evaluation and to curtail long-term adverse impacts on survivors. This family-based primary prevention effort is a framework for healthcare practitioners to use and includes strategies (i.e., health history, mental health evaluation, family dynamics evaluation) that are child and family centered contributing significantly to positive social change.

Biography:
Dr. Analena M. Lunde is a Professor of Nursing teaching in the Associate of Applied Science and Bachelor of Science in Nursing programs. She is a certified sexual assault forensic nurse (adult/pediatric) serving as an advisor on state and national forensic/human trafficking councils, policy development, education, and practice translation.
Dr. Lunde earned her Doctorate in Nursing Practice from Walden University. Her recently published work “Trauma-Informed Education Toolkit for Screening Pediatric Victims of Sexual Abuse and Maltreatment”, has been accepted and implemented for the Central Dakota Forensic Nurse Examiners program. She was named 2018 Nurse Educator of the Year and 2018 Outstanding Faculty of the Year.

A Deanʼs Journey: Revitalizing a School of Nursing

Deborah Zbegner

Wilkes University, USA

Background: The School of Nursing, located within a small university residing in the northeast region of Pennsylvania, was joined with the School of Pharmacy and governed by the Pharmacy dean. The School of Nursing struggled with declining morale, mediocrity, identity, and attaining stellar board scores. The President decided that change was necessary and separated the schools, thus creating an independent School of Nursing. The task for the School of Nursing was to develop its own identity and flourish within the university and community. A search was conducted and a new dean emerged to lead the school.

Process: The process for change revolved around creating an organizational structure that would stimulate faculty, staff, and student productivity, increase overall morale, and create sustainable program growth. Faculty, students, and curriculum were analyzed separately and collectively within the context of the school and university. he first year focused on communication, conducting a SWOT analysis and extensively interviewing faculty, staff and students. A combined hierarchical matrix organizational design emerged and faculty and staff began functioning under the new structure.

Results: Four years later, the organization structure remains in place and the School of Nursing redefined its committee structure, process for evaluation, and the role of faculty and staff. The school is now endowed for 3.3 million dollars, increased its profile of programming, and has grown to approximately 1000 students between undergraduate and graduate departments. NCLEX-RN pass rates dramatically increased to above 90% for the past two years and Nurse Practitioner certification pass rates are consistent between 95 and 100% depending on the program. The School of Nursing has increased its national visibility, prestige, and university support.

Process Strategies for Course Redesign: Population Health Course

Emily Harvilla

Wilkes University, USA

Background: Curricular evaluation and redesign is an ongoing process within baccalaureate nursing programs that is implemented to ensure consistency with educational standards, incorporate evidence-based recommendations for practice and education, and maintain relevancy with the ever changing healthcare industry. Through one programʼs recent curricular redesign, the need to significantly change the didactic content and learning strategies in the area of community health and population health was identified. The evolution from a focus on community health nursing to population health nursing is consistent with current trends in nursing practice and healthcare.

Process: The process of course redesign was linked to the programmatic curricular changes which were grounded in the American Association of Colleges of Nursing (AACN) Baccalaureate Essentials and Quality and Safety Education for Nurses (QSEN) Competencies. Specific course development included review of current literature and population health organizational information to identify appropriate content and best educational strategies for the achievement of student learning outcomes. Opportunities for student clinical experiences were identified through an assessment of community and population needs, as well as through the development of ongoing professional relationships with community partners. The revised undergraduate program syllabus template was used for consistency in the identification of content, teaching strategies, and student learning outcomes.

Results: A population health course was developed to engage students through multiple teaching-learning strategies including the addition of service learning, simulation, and a literature assignment. These strategies in conjunction with traditional strategies will foster student learning and create a positive learning environment designed to foster future civic engagement.

Does Opioid Pain Management Prescribing Impact the Opioid Epidemic?

Marc E. Aube

Massachusetts College of Pharmacy and Health Science, USA

Opioid-pain-medications overdoses have been increasing since 1999 to the point of being an epidemic. This has led the President of the United States to declare the opioid epidemic a public health emergency. This public health emergency is related to the fact that deaths from drug overdoses have become the leading cause of preventable death in the United States from injuries, exceeding deaths from motor vehicle accidents. This paper aims at 1) establishing the link between the current opioid epidemic and the contributing role of the prescribing practice; 2) increasing awareness of the potential effects of inappropriate prescribing and opening new horizons; 3) issuing a call for standardized national pain-management guidelines which would help prescribers obtain the best positive health results; and 4) demonstrating that inappropriate prescribing not only harms the patient but also increases costs which place financial burdens on our healthcare systems. The economic burden which is also growing annually has become unmanageable.

Providers in the United States (US) have pain-management guidelines which, however, are not nationally applied. Vast differences exist in the interpretation and/or application of those guidelines. Apparently, the effects of social-norm related prescribing are still not fully understood. The American Academy of Pain Management (AAPM) maintains that, because the treatment of pain varies from one prescriber to the other, it has sometimes led to both under and overprescribing. In an attempt to remedy this situation, AAPM has proposed, for its members and colleagues, pain-management practice guidelines based on new evidence, finding and concepts about pain, pain assessment and its treatment. The overuse of opioids in the United States could be a result of physician prescribing practices. However, the individual physicians prescribing practice has not been studied extensively. The ramifications on long term outcomes is also unknown.

Biography:
Marc Aube is a full-time Registered Nurse and graduate student at Massachusetts College of Pharmacy and Health Science. After working many years as a phlebotomist, his wife and three children encouraged him to follow his “nursing” dream. Marc, while maintaining full-time employment, pursued an Associate Degree followed by a Bachelor of Science in Nursing. Finally, Marc pursued his life-long goal of Masterʼs level nursing. In his practice, the opioid epidemic awakened his need to be part of the solution to this crisis.

Prevalence of Geriatric Syndromes and Dementia in a Geriatric Clinic

Pitiporn Siritipakorn*, Weerasak Muangpaisan, Dujprathana Pisalsarakij, Pensri Chaopanitwet, Praitoon Laojan, Sutisa Pitiyarn and Napaporn Pengsorn

Mahidol University, Thailand

This research aimed to survey the prevalence of geriatric syndromes and dementia in a Geriatric Clinic, Siriraj hospital, Mahidol University, Bangkok, Thailand. The sample consisted of 1, 171 patients, accounting for 95% of the patients who visited a doctor during January to July 2017. The instruments used in the study were the geriatric syndromes screening questionnaire and medical record review to evaluate the symptoms over a period of prior 3 months before the survey. Data were analyzed using descriptive statistics and Chi- square test.

The findings revealed that the majority of caregivers were female (67.5%) with the average age of 79.3 years. (SD=7.8). The five most common geriatric syndromes were dementia (40.6%), followed by incontinence (38.0%), sleep problem (26.4%), fall within 3 months (12.0%) and anorexia (11.6%). Persons with dementia had at least 2 other geriatric syndromes. The variables significantly associated with dementia were age (p <.05), gender (p <.05) and the self-care ability (p <.001). Geriatric syndromes associated with dementia were falls (p <.05), incontinence (p <.001), and delirium (p <.001).

The results of this study raise the awareness of screening geriatric syndromes which require the thorough assessment. Although some of geriatric syndromes cannot be prevented to occur, planning for care and surveillance can prevent complications and might reverse the conditions. The older adults with dementia usually had other geriatric syndromes. Risk of complications is greater than those without dementia. Therefore, special evaluation and management in this particular group should be implemented.

Biography:
Miss Pitiporn Siritipakorn is a senior professional nurse who earned Bachelor and Master Degree of Science in Nursing from Mahidol University. She has 18 years of nursing experiences. Her goal is to be an expert in dementia care. Her inspiration comes from her personal experiences as a caregiver for her mother who had Alzheimerʼs disease for 13 years. Apart from her inpatient care for medical patients, she also works as a clinical nurse specialist in Geriatric Clinic at Siriraj Hospital, Bangkok, Thailand. She is a dementia educator for nurses, family caregivers who suffer from taking care of persons with dementia.

Development of an Augmentative and Alternative Communication app. for Makaton

Susan Carlisle

Queenʼs University Belfast, UK

Introduction: As part of the theme of communication in phase one undergraduate nursing curriculum students are asked to produce an information leaflet to help enhance communication with patients and clients.

As a result of this exercise students were finding out about Makaton as an AAC and asked if they would have opportunity to learn this skill as part of the programme.

Aims & Objectives: The development of a Makaton training app. for use in undergraduate nursing.

Objectives:

  • To develop a teaching tool on Makaton that is up to date, current and easily accessible to all undergraduate nursing students
  • To provide undergraduate nursing students with the information and skills necessary to engage with patients/clients with a communication deficit.

Methods:

Stage 1: Purchase the license for Makaton
Stage 2: The development of a teaching tool template that includes all the essential aspects required for Makaton training.
Stage 3: Collaboration with a computer technician to produce video clips, podcasts, interactive tests and hyperlinks to key areas.
Stage 4: Transferring the multimedia outputs into an app. accessible for students.
Stage 5. Pilot app. with year 1 undergraduate students and year 1 teachers
Stage 6: App. made available to all year 1 students.
Stage 7: Evaluation of app.

Outcomes: By providing nurses with an easy to use aid memoire this should improve communication and clientʼs satisfaction with the service.

The importance of Makaton as an Augumentative and Alternative Communication methods is highlighted.

Conclusion: It is hoped that by developing this app. nursing students will have a greater understanding of communication deficits and be able to provide patient centered care that is considerate to the individualʼs needs.

Prevalence of Burnout Syndrome in Clinical Nurses at a Hospital of Excellence

Vivian Finotti Ribeiro

Universidade Federal de São Paulo, Brazil

Background: Burnout syndrome can be defined as long-term work stress resulting from the interaction between constant emotional pressure associated with intense interpersonal involvement for long periods of time and personal characteristics. We investigated the prevalence/propensity of Burnout syndrome in clinical nurses, and the factors related to Burnout syndrome associated such as socio-demographic characteristics, work load, social and family life, leisure activities, extra work activities, physical activities, and work-related health problems.

Method: We conducted a cross-sectional, quantitative, prospective epidemiological study with 188 surgical clinic nurses. We used the Maslach Burnout Inventory (MBI), which is a sociodemographic questionnaire and the most widely used instrument to assess Burnout syndrome (three basic dimensions: emotional exhaustion, despersonalization and professional underachievement). The socio-demographic profile questionnaire was composed of questions regarding identification, training, time at work, work characteristics and personal circumstances.

Results: The prevalence of Burnout syndrome was higher (10.1%) and 55, 4% of subjects had a propensity to develop this syndrome. The analysis of the socio-demographic profile of the nurse sample studied showed that most nurses were childless married women, over 35 years of age, working the day shift for 36 hours weekly on average, with 2-6 years of post-graduation experience, and without extra employments. Factors such as marital status, work load, emotion and work related stress aggravated the onset of the syndrome.

Conclusion: The prevalence and propensity of Burnout syndrome were high. Some factors identified can be useful for the adoption of preventive actions in order to decrease the prevalence of the clinical nurses Burnout syndrome.

The prevalence and propensity of Burnout syndrome were high. Some factors identified can be useful for the adoption of preventive actions in order to decrease the prevalence of the clinical nurses Burnout syndrome.

Keywords: Burnout, Professional, Syndrome, Nursing

Biography:
Vivian Finotti Ribeiro is a nurse graduated from the Federal University of Uberlândia- UFU(MG) for 16 years. PhD in Health Sciences since 2015. Assistant coordinator and Professor of Postgraduate courses at the Faculdade Israelita de Ciências da Saúde Albert Einstein. Postdoctoral student of the Federal University of São Paulo- UNIFESP(SP).

Life of Postmenopausal Women

Nirmala Rathnayake*, Gayani Alwi, Janaka Lenor and Sarath Lekamwasam

University of Ruhuna, Sri Lanka

Menopause and related symptoms impair the overall health related quality of life (HRQOL). Health promoting life-style education is a cost effective approach to overcome such issues. This study aimed to evaluate the impact of a health promoting life-style modification education intervention on HRQOL of postmenopausal women (PMW). A quasi-experimental study was conducted with age and sociodemographic status matched 72 PMW (divided as experimental n=37 and control n=35 groups) randomly selected from Galle, Sri Lanka. Health promoting education intervention focused on postmenopausal health management including life-style modifications(diet, physical activities, psychological adjustments…etc) was performed during 8 weeks and printed health education package including life-style modifications was provided at the end only for the experimental group. Short form 36 survey was self-administered to assess the HRQOL of the participants in two groups before the intervention, just after the intervention and after 6 months follow-up. The differences within and between the experimental and control groups were analyzed with independent sample t test and repeated measure ANOVA test using SPSS 20.0. Mean(SD) age of experimental and control groups were 54.6(4.5) and 56.5(3.4) (p=0.06) years respectively. Before the intervention, HRQOL scores were not significantly different between experimental and control groups (p>0.05). However, after 6 months follow-up, all the domains of HRQOL (except the social functioning and pain domains) and overall HRQOL scores were significantly increased (p<0.001) in the experimental group. In the control group, significant reductions of HRQOL were observed in all the domains (except the energy or fatigue and pain domains) and overall HRQOL (p<0.05) in the follow-up evaluation. This study proved that the health promoting education intervention focused on life-style management after menopause was an effective in improving HRQOL in postmenopausal women. The usefulness of such interventions needs to be confirmed in a larger study.

Keywords: health promoting life-style modification education intervention, health related quality of life, postmenopausal women, Sri Lanka

Assessment of Factors Contributing to Phlebitis among the Patients admitted in Medical-Surgical Units of BPKIHS

Ram Sharan Mehta, Rana S, Parajuli P and Mandal G

B.P. Koirala Institute of Health Sciences, Nepal

Background and Objectives: Phlebitis, an inflammation of the tunica intima of vein by mechanical, chemical or bacterial sources, is the main local complication associated with peripheral intravenous cannula and, occurs between 3.7% and 67.24% of patients. It causes significant pain; discomfort; failure and interruption to prescribed therapy; and requirement for new cannula insertion with associated increased equipment costs and staff time. Cannula related bacterial sepsis can jeopardize patientʼs life. The main aims of this study are to assess the contributing factors of phlebitis among admitted patients in Medical-Surgical Units of BPKIHS and to find out the association between selected variables and phlebitis.

Materials and Methods: Descriptive cross-sectional design was adopted to conduct the study among 120 admitted patients with cannula having phlebitis in Medical-Surgical Units of BPKIHS. Data was collected from December to January 2016 for 4 weeks using interview questionnaire and observation checklist and later analyzed using descriptive (mean and standard deviation) and inferential (Chi-Square Test) statistics using SPSS 16 version.

Results: Mostly (45.8%) moderate phlebitis was observed followed by mild (39.2%) and severe (15%) in the subjects. Most of the subjects (47.5%) were between age group 30-60 years with more than 7 days of hospitalization (80.8%). Most of them had 20G cannula (76.7%); inserted in wrist (49.2%); first insertion (33.3%); successful in first attempt (83.3%); in ward (78.3%); by Nurses (97.5%); under antibiotics (90.8%) and intermittent infusion (55.8%). Significant association was found between age, Residence, ethnicity, body weight and phlebitis.

Conclusion: Considerable moderate and severe phlebitis in the study subjects are crucial findings. It can be concluded that phlebitis is independent of cannula and infusion related contributing factors.

Keywords: Contributing factors, Phlebitis, Patient