Madridge Journal of Nursing

ISSN: 2638-1605

6th International Conference on Nursing and Health Sciences

December 2-3, 2019, Kuala Lumpur, Malaysia
Scientific Session Abstracts
DOI: 10.18689/2638-1605.a4.006

The Effect of Activity Participation on the Days of Bedridden for Institutional Residents before DeathAn Observational Study of One Nursing Home

Yi-Ting Lo1,2*, Ching-FengLai2, Shang-Wei Hsu1, Yu-Chia Chang1 and Hui-Wen Chien1

1Asia University, Taiwan
2Nightingale Nursing Home, Taiwan

The idea of successful aging and a good death is everyoneʼs wish in their later life. With advanced medical technology care services extends human live longer than ever. Contrary to this positive outcome a lack of regular exercise and diet control leads to an increase of chronic disease and disability.

In 2015, according to the Ministry of Health and Welfare in Taiwan people with functional disability reached about 760,000 persons, with an expected projection of 1,200,000 persons in 2031. As a consequence people with disability and catering for their care needs are expected to become a major expenditure of the health care system. Not only the cost taken from the national medical health care and social welfare budget, but also a burden for each individual family with their supplementary care provision and financial support. Therefore, to understand how to reduce the level of disability and their length of being bedridden prior death is of importance.

Aim of Study:

• To understand the affect upon nursing home dying residentʼs number of being bedridden by providing them with nonpharmaceutical therapy, physiotherapy and exercise

• To explore the factors that affect the chronic physically Declining residentʼs participation to the activities offered in a nursing home.

Research Design: The study used a secondary data analysis of a retrospective longitudinal data set of the nursing home deceased residents. Data were collected from 1st March, 2012 to 31st May, 2016, excluding severely disabled residents and those diagnosed as terminally ill. Data collection include: demographic characteristics, participation to the activities and bedridden days prior death.

Data Analysis: Descriptive statistics were be used to describe the demographic characteristics of participants. In addition, T-test, ANOVA, Multiple Regression Analysis, Multinomial Logistic Regression Analysis and Survival analysis were used to analyze the data.

Result: The finding shows less bedridden prior death residents were those with higher score of ADL and frequently participated to 2 and more activities. Single and widows residents revealed a 25 times higher activity participation rate than those married and de facto. In regards to the group of residentsʼ bedridden prior to death less than 30 days, they were showed a 100 times higher active participation of a single activity, in comparison to those bedridden more than 90 days.

In conclusion, from being active to the length of being bedridden prior to death, it was revealed a lower bedridden period was dependent upon a higher rate of participation of activities and exercise. Those residents also showed to have better physical functional ability and quality of life prior to becoming bedridden. In regards to the remaining family response they reported a better memory and ending for their love one compared to the perception of a lingering traumatic extended bedridden state.

Yi-Ting Lo is come from Taiwan. His major is nursing and management. After he graduated from the nursing department in 1999, He worked in the clinic hospital. In 2015, He study Doctoral program of health industry management at Asian University. Currently he was an operator with residential institution, Non-profit foundations and home nursing companies, etc., the main research domain are elderly care and hospice palliative care.

Physical Activity, Enjoyment and Quality of Life among Institutionalized Older Adults: A CrossSectional Study

Nizar Abdul Majeed Kutty*, Mohammed Abdulrazzaq Jabbar and Ng Kyie

University Tunku Abdul Rahman, Malaysia

Increasing Physical activity (PA) among elderly persons has become an international priority. However, it is unclear how physical activity patterns are associated with enjoyment of PA and health-related quality of life (HRQoL) among institutionalized older adults. A sample of institutionalized older adults (n = 134, mean age=73.72; SD=8.59) from the Klang valley in Malaysia was recruited. In cross-sectional analyses, PA, enjoyment of physical activity and quality of life were screened using Physical Activity Scale for the elderly, 8-item Physical Activity Enjoyment Scale and EuroQuol-5 Dimensions-5 Levels questionnaires respectively. High levels of physical activity were associated with enjoyment of PA and HRQoL. A total of 41% subjects met the guidelines of physical activity for elderly and 53% of the participants enjoyed PA. Positive correlation was found between level of PA with enjoyment of PA (rs = .355, p < .001). Significant correlations were recorded between the dimensions of HRQoL and the level of PA (p < 0.001) except pain / discomfort and anxiety / depression. Providing opportunities for institutionalized older adults to engage in a variety of activities might help them identify PA they enjoy and facilitate lifelong PA habits.

Mr. Nizar is an astute physical therapist and sagacious rehab science researcher currently working as Senior Lecturer in Physiotherapy at University Tunku Abdul Rahman, Malaysia. His commitment to teaching excellence has earned him accolades. His research interest spans a variety of topics in obesity, physical activity and sedentary behavior. He presented his research findings at international conferences, published articles in prolific journals and was awarded with scholarships and research grants. Mr. Nizar served as Head of Department of Physiotherapy at Mahatma Gandhi University, Kerala, India. He writes health care articles for periodicals and national dailies.

Emotional Intelligence as a Predictor of Nursesʼ Well-Being

Leila Karimi1, Sandra G. Leggat1, Leila Afshari1 and Timothy Bartram2

1La Trobe University, Australia
2RMIT University, Australia

Aim: To investigate the effect of emotional intelligence on well-being, psychological empowerment and quality of care.

Design: The baseline data for the present project were gathered from 2014 - 2015 through an aging setting and a proposed model of the study was designed. The model fit was evaluated using structural equation modelling by AMOS software.

Methods: A convenience sample of 78 employees from a Victorian aged care organisation.

Results: The evaluated model confirmed that emotional intelligence predicts employees psychological empowerment, wellbeing and quality of care in statistically significantly way.

Conclusion: This study suggests that emotional intelligence contributes strongly to employee engagement and adds valuable skills that are important in working with aged care residents and other stakeholders.

The Impact of Constipation on Quality of Life of Chronic Kidney Disease (CKD) Patients in Malaysia

Nurhayati Mohamad Nor*, Lee Yeong Yeh and Nurhazwani Hamid

Universiti Sains Malaysia, Malaysia

Background: Chronic Kidney Disease (CKD) is a growing chronic disease in Malaysia, the prevalence of chronic kidney disease is high (9.1%). Constipation is common among CKD patients and has been associated with a decline in quality of life. Our study aimed to evaluate the quality of life (QOL) of CKD patients with constipation.

Methods: This descriptive cross-sectional study was conducted from October 2017 to March 2018 and included 312 patients from 3 hospitals located in Malaysia (i.e., Hospital USM, Hospital Raja Perempuan Zainab II and Hospital Serdang). Using Kidney Disease Quality of Life-36TM (KDQOL-36) questionnaire, patients were interviewed in Malay to gather information on Physical Health Composite Summary (PCS), Mental Health Composite Summary (MCS) and Kidney Disease Composite Summary (KDCS) domains. Data entry and analysis was done using SPSS version-23.

Results: Among the 387 CKD patients, we found (n = 276) having constipation. The mean score of KDQOL was 70.65 ± 9.79, Physical Health Composite Summary (PCS) 62.86±18.26, Mental Health Composite Summary (MCS) 56.34 ± 19.79 and Kidney Disease Composite Summary (KDCS) was 70.65 ± 7.49. There was a significant relationship between constipation and MCS and KDCS (p <0.05). Only sub-scales of general health in PCS were significant (p < 0.05). Emotional well-being, Social function, Energy or fatigue, the MCS sub-components showed significant association with constipation (p < 0.05). Similarly, symptoms, effects of kidney disease, the burden of kidney disease, quality of social interaction, sleep, social support, encouragement and satisfaction, which are sub-components of KDCS also showed a psychotic association (p < 0.05) with constipation.

Conclusion: The QOL is significantly reduced for most CKD patients with constipation especially mental and CKD disease burden. The lowest score is found in the KDCS, Burden of kidney disease 39.61 ± 29.07, followed by MCS, Emotional wellbeing 44.06 ± 34.38 and PCS, General health 46.67 ± 19.58.

The Role of Allied Health Professionals

Navin Kumar Devaraj

Universiti Putra Malaysia, Malaysia

Background: Having been in the medical field for close to 20 years since starting my medical school in 1998, I have always appreciated the role of allied health professionals, notably staff nurses and medical assistants (known also as assistant medical officer) in helping out physician in ensuring patients receive the best health care services.

Both this group of staffs are designated different kind of duties. Staff nurses are usually given the task to take care of patientʼs need from nutrition to serving of medication while medical assistant, who are mainly working in the emergency unit of a clinic or hospital, are in charge of triaging patient and taking of blood specimens.

Methods and Results: Over the years, one issue seems to trouble me. While the role of medical assistant remains the same, the role of the staff nurses has somewhat been reduced. The duties of taking blood, setting of intravenous drips and given stat drugs through the intravenous route have been “shifted” to physicians.

Part of the reduced duties can be attributed to nursing teaching curriculum which had slashed this important component. I have over the years ask nursing students who have confirmed this rather drastic curriculum shift. While agreeing that physician can help in taking blood and setting up of intravenous drips, the division of duties can further create a gap between physician and nurses that will have an influence on the working relationship.

I feel training in blood taking and setting up of intravenous drips still needs to be incorporated in nursesʼ training as these nurses may be posted to rural areas where they may be alone in charge of a smaller health unit called village / rural clinic where they may encounter pregnant ladies with urgent need of intravenous hydration e.g., in cases of ectopic pregnancy and placenta previa and nearest help may be about 10-15 minutes away. Even if these nurses work in an urban hospital and clinic, their skills will be an invaluable asset in helping reducing the physician loads, especially during on- call duties.

Conclusion: What hold forth is still high-quality patient care. The healthcare team needs to work together to achieve these aims. Over times the load of patients will increase and therefore I feel everyone should upgrade and share their expertise in managing patients.

Dr. Navin Kumar Devaraj is a senior lecturer and Family Medicine Specialist at Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. He has published more than 30 articles in peer-reviewed journal. His area of interest is hypertension and stroke. He has work with various allied health department including nursing, occupational health and environmental health departments.

Early Detection of Disabilities among Infants 0-1 years of Age through the Implementation of Periodic Developmental Assessment in Primary Care Setting

Aminah Bee Mohd Kassim* and Lidwina Edwin Amir

Family Health Development Division, Ministry of Health, Malaysia

Introduction: The Ministry of Health Malaysia has taken initiatives to improve the early detection of developmental delay among children aged 0 to 6 years through regular clinic visit and developmental screening tests. The revised child health record book (2008) included specific developmental screening at specified intervals, red flags for the various developmental domains namely gross motor, vision and fine motor, speech and language as well as social skills. To improve developmental assessment skills, nurses in primary care were trained in a multilevel training approach where intensive assessment and reassessment activities was carried out in 2014.

Objective: To analyze the outcome of skills training implemented.

Methods: Descriptive analysis of the findings from the training and administrative data collected by the Family Health Development Division

Results: Eighty percent of the infant population in one birth cohort attends government health clinics for regular growth and developmental assessment. There has been an increase in cases detected early from 566 in 2013 to 948 cases in 2018 i.e. a 67% increase in number of cases detected and referred for intervention.

Conclusion: Training of nurses increase the early detection of disabilities among infants.

Dr. Aminah Bee Mohd Kassim is a Public Health Medicine Specialist with the Family Health Development Division, Ministry of Health Malaysia with special interest in Child Health and Disability. She has been in service for the past 32 years and involved in development of policies, guidelines and protocols as well as development of manual and training modules related to early detection of disabilities, early intervention and rehabilitation services. She has participated in research related to disabilities and child development and is very much involved and passionate about training of health staff, teachers and care providers on early intervention for children with special needs.

Early Detection of Autism Spectrum Disorders in Malaysia using M-CHAT for Screening in Primary Care Setting

Lidwina Edwin Amir* and Aminah Bee Mohd Kassim

Family Health Development Division, Ministry of Health Malaysia, Malaysia

Introduction: Early detection of Autism Spectrum Disorders (ASD) is important to ensure children are referred for interventions early leading to better long-term outcomes. A study on school age outcomes of children who received interventions before the age of 3 years and those with late diagnosis of ASD reported that cognitive and behavioral outcomes of children diagnosed early was better. Nurses in health clinics used the M-CHAT incorporated into the Child Health Record Book for screening. This was implemented nationwide in 2012 and after more than 5 years of implementation, it is time to evaluate the use of the tool.

Objective: To evaluate the outcome of implementing M-CHAT as a screening tool in primary care clinics.

Methods: Descriptive analysis of the trend for detection of cases suspected to be ASD using administrative data collected by the Family Health Development Division.

Results: Eighty percent of children aged 18 months were seen and screened in government health clinics. There was an increase in trend for detection of cases suspected with ASD from 1.47 per 1000 in 2015 to 3.26 per 1000 in 2018. Cases were seen by specialist and oncediagnosis was confirmed the children were given intervention. Similarly, cases screened for autism among children aged 3 years showed improvement from 1.5 to 2.79 per 1000 during the same period. In addition, data shows cases were being detected and confirmed earlier before school going age.

Conclusion: The use of M-CHAT as a screening tool in primary improved early detection of ASD.

Keywords: ASD, M-CHAT, screening, early detection, intervention

Ms. Lidwina Edwin Amir is the Chief Nursing Supervisor (Matron) in the Child Health Sector, Family Health Development Division of The Ministry of Health Malaysia (MOH). Graduated with Basic Nursing, Midwifery at Nursing College Queen Elizabeth Hospital, Public Health Nursing at IKU JalanBangsar, BSc in Nursing (Hons) at UNIMAS Sarawak and MSc. in Nursing (Hons) Hertfordshire University U.K. Has served in the MOH for 29 years and currently responsible for planning and monitoring the implementation of the National Immunization Program as well as the Care Program of infants and children in the national nursing field.

Patient Self-Management Intervention-Evidences for Health Professionals in Asia Pacific

Loh Siew Yim

University Malaya, Malaysia

Background: Research on the efficacy of patient self-management interventions on many chronic conditions and its significance in cancer population is slow, but the evidences are emerging even in developing countries with lower-resources.

Objectives: The aim of the presentation is to discuss the evidence on the efficacy of intervention in a low resource country like Malaysia by highlighting findings from (1) 4 week CDSM trial on quality of life (QOL) and on distress and limitation in participation (secondary outcomes); for women with breast cancer.

Methods: A clinical controlled trial with the experimental arm receiving the program and usual care and the control arm received usual care only. The intervention was conducted over 4 weeks (2-hour / week), as a facilitator-led program using selfmanagement approaches.

Results: 147 women diagnosed with breast cancer within the last 6 months participated. MANCOVA (adjusted for baseline measures) demonstrate significant differences between groups [F (6,129) = 2.26, p = 0.04 at post-test and F (6,129) = 4.090, p < 0.001 at follow-up]. Post hoc analysis indicated significantly better outcome on all measures. At follow-up the experimental group had a mean QOL score of 3.39 [CI = 1.37 – 5.42; p = 0.001] greater than the control. The intent-to-treat analyses showed beneficial outcomes for women receiving usual care plus self-management. A 2 years follow up showed positive significant improvement in QOL of experimental group.

Conclusion: Breast cancer now takes a form of chronic illness. Patient self-management program showed improved health outcomes and enhanced QOL

Implications: Survivors receiving supportive programme reported improved QOL. Although time can attenuate the participation limitation and distress of survivors, supportive programmes could help to increase patients' self-efficacy for better self-management. Timely to also consider beyond mere survival issue into work and occupational participation as people live indefinitely with cancer.

“Role of High-Voltage Pulsed Current in Management of Bed Sore”: A Short Review of Literature

Tarun Amalnerkar* and Jacob Swapneela

Department of Physiotherapy, Universiti Tunku Abdul Rahman, Malaysia

Introduction: Bed sore is one of the most common inevitable complication of immobility in both acute and chronic clinical settings. Physiotherapists have been involved as an essential team member for prevention and management of bed sore. Electrotherapy modalities such as LASER, Ultrasound etc., are being used for treating the bed sore. Physiotherapist are also involved in frequently changing, advising on specific weight reliving positioning especially with neurological diseases and disorders. Different mode of application of High voltage pulsed current has also been used for tissue healing in inflammatory phase/infected & proliferation phase. This review is an attempt to put light on the use of HVPC as treatment adjunct.

Method: A pub-med search has been made in November 2019 a period of last ten years for available abstracts. Key term such as (High Voltage Pulsed Current, Bed Sore) with best match search information was (MeSH Terms: heart rate; pulse; pressure ulcer) has been used. No specific selection over human and other animals were made. We found 10 corroborated works.

Conclusion: Few studies have shown the use of high voltage pulsed galvanic currents as a treatment modality. The results were encouraging. An extensive search should be made on various data base so that further concepts & gap in the knowledge can be explored. Clinical studies should be conducted based on the findings as there is a potential of making specific treatment protocols which can abet quality of life of patient and care giver. At the same time, it can abet health care professionals & may reduce the unavoidable burden on health care system.

Tarun Amalnerkar has completed his Masters in Physiotherapy - Neurology from India. His interest of research is Physiotherapy in Neurological disease and disorders (especially movement disorders), Sleep medicine, Humanity. He has presented scientific papers and reviews several conferences and have written for health magazines, newspaper. He is also involved in broadening knowledge of physiotherapy to the community with various organizations.

High Intensity Interval Training Associated with Lower Waist Circumference and Fat Percentage at the Trunk Region in the overweight Young Population

Imtiyaz Ali Mir1*, Lai Pei Ting1 and Mohammed AbdulRazzaq Jabbar2

1Department of Physiotherapy, Faculty of Medicine and Health Sciences, Tunku Abdul Rahman University, Malaysia
2Department of Population Medicine, Faculty of Medicine and Health Sciences, Tunku Abdul Rahman University, Malaysia

Background: The prevalence of obesity and overweight is high among the physically inactive adults. Lack of time is found to be the main barrier to exercise in this population, thus, it is important to develop a short duration, time-efficient training protocol to overcome this problem.

Method: 30 participants (male, n=15; female, n=15) were recruited using block randomization and divided into two equal groups; experimental (high intensity interval training, HIIT n=15) group and control (CON n=15) group via lottery method. Experimental group performed 4×4 bouts of HIIT, (one minute 85%-90% maximum heart rate with 4 minutes of active recovery at 65%-70% maximum heart rate) for 4-weeks, 3-sessions/week on alternate days. CON group did not participate in any kind of training. Body mass index (BMI), waist circumference (WC) and fat percentage at trunk region (FPTR) was assessed at baseline and 1 day after completion of training.

Results: The mean ± SD age for HIIT group was 20.57 ± 1.34 and CON group was 21.80 ± 1.82. A two ways mixed method ANOVA showed statistically significant positive changes in HIIT group in WC and FPTR compared to CON, (WC mean difference = 2.33 vs -1.34, F (1,27) = 5.81, p = 0.024, partial η2 = 0.276), (fat percentage at the trunk region mean difference = 1.48 vs -0.49, F (1,27) = 4.17, p = 0.046, partial η2 = 0.194), and a negligible difference in BMI (mean difference = 0.04 vs -0.31, F (1,27) = 3.621, p = 0.68, partial η2 = 0.118). Between group comparisons showed no significant differences among all the three outcome variables.

Conclusion: Short period of 4-weeks HIIT has positive effect on anthropometric outcome measures particularly on WC and fat percentage at the trunk region and is a recommended time efficient type of training protocol for overweight population.

Mr. Imtiyaz Ali is a versatile, enterprising & resourceful physiotherapist with more than 12 years of rich experience in the healthcare sector & academic industry in Malaysia. He has extensive experience in clinical guidance, research supervision, curriculum design, delivery & assessment. Mr. Imtiyaz Ali is a subject matter expert, recognized for providing innovative & intellectually stimulating teaching thereby producing very best professionals. In addition, he has 6 journal and 2 book publications under his name.