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Editorial
Do Nurses have Power to Influence Politics and Healthcare Policies Relevant to Nursing? (Punitha Ezhilarasu)

Concepts and Issues
Telenursing in Comtemporary Practice (Dorothy D. Theodore, Priyadarshini L. Byrappa)

Clinical Article
Alcohol Withdrawal: A Case Report (Santhi L. Johnson, Velvizhi Theerthagiri, Manoranjitham Sathiyaseelan)
Caring for a Patient with Sacral Schwannoma: A Case Report (Asha Solomon, Andrew A.Anandan)

Research Article
Sleep Quality and Pain Intensity among Elderly Patients Undergoing Orthopedic Surgeries (Niramala M. Emmanuel, Punitha Ezhilarasu, Angela Gnanadurai, Vernon N. Lee)
Effectiveness of Structured Teaching Program on Knowledge of Anganwadi Workers Regarding Mental Health and its Problems in Children (Dhanya M. Sebastian, Dorothy D. Theodore)
Effectiveness of Childbirth Preparation on Anxiety and Self Efficacy of Primigravid Women (Anu S. Kuruvilla, Christy Simpson, Nirmala Manoharan, Annie Regi)

Continuing Education Series No: 28
Burn Management: Challenging Role of Burn Nurses – Part I (Beulah Premkumar, Regina Xavier, Alice S. Kumar, Jabin Khaja, Prasanna K. Sathiyanathan, Harini Srinivasan, Kalaivani Gnanamani)

Student Section
Dravet Syndrome: A Case Study (Honey Augustine, Ibamedari Warbah, Deena Edwin)

Research in Brief
Effectiveness of a Planned Teaching Program on Knowledge and Skills Regarding Communication among Adolescents (Kenneth S. Guddeti, Dorothy D. Theodore)
Perceived Stigma and Quality of Life among Transgenders (Nanzy, F. M, Rogina J. S. Savarimut)

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Abstracts

TELENURSING IN CONTEMPORARY PRACTICE
* Dorothy D. Theodore, M.Sc (N)., Ph.D (N), ** Priyadarshini L. Byrappa, M.Sc (N)
* Principal, Narayana Hrudayalaya College of Nursing, Bengaluru, ** Assistant Professor, Narayana Hrudayalaya College of Nursing, Bengaluru
ABSTRACT
Advancement in healthcare system is booming with information technology at the forefront. Nursing being a major part of the healthcare system cannot lag behind. Nurses need to be adequately equipped with the required knowledge and skill in contributing to the utility of the technological advancement. Telenursing is one such advancement which is developing at a fast pace. Telenursing is becoming an essential means of providing care due to factors such as affordability, accessibility of services to the unreached and immobile sections of the society such as elderly and chronically ill, and shortage of specialists among healthcare professions. This article discusses various aspects of telenursing such as history, scope, and its use. It also presents a framework applicable to telenursing. The various challenges faced by nurses in implementation of telenursing alongside legal and ethical aspects are discussed.

Keywords: telemedicine, telenursing, principles, organization, nursing competencies, ethical issues, ethical challenges
REFERENCES

ALCHOL WITHDRAWAL: A CASE REPORT
* Santhi L. Johnson, M.Sc (N), ** Velvizhi Theerthagiri, B.Sc (N), *** Manoranjitham Sathiyaseelan, M.Sc (N)., Ph.D (N)
* Lecturer, College of Nursing, CMC, Vellore, ** Charge Nurse, CMC, Vellore, *** Professor, Dept. of Psychiatry Nursing, College of Nursing CMC, Vellore
ABSTRACT
Alcohol withdrawal is a set of symptoms seen in an individual who reduces or stops alcohol consumption after prolonged periods of alcohol intake. Withdrawal signs and symptoms are usually minor, but they can be considerable and even fatal. Alcohol withdrawal delirium commonly known as Delirium Tremens or ‘DTs’, is the most serious manifestation of alcohol withdrawal syndrome. Nurses play a major role in early identification and management to rehabilitate these patients. A case report is presented in this article including clinical presentation, diagnostic measures and management.

Keywords: alcohol withdrawal, alcohol withdrawal syndrome, delirium tremens, nurse’s role, management, case report
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CARING FOR A PATIENT WITH SACRAL SCHWANNOMA : A CASE REPORT
* Asha Solomon, M.Sc (N), ** Andrew A. Anandan, RN., RM
* Reader, College of Nursing, CMC, Vellore, ** Staff Nurse, CMC, Vellore
ABSTRACT
Schwann cells are a type of glial cells found in the peripheral nervous system (PNS) that form myelin sheath around the PNS neurons. Schwannoma is a slow growing benign tumor of Schwann cells and among the bony sites, sacrum is the most common site of involvement. Removal of the tumour by sacral amputation followed by lumbo pelvic fixation is usually the preferred treatment. Patients who undergo removal of sacrum have a high chance of bowel and bladder dysfunction along with sensory loss and motor weakness of lower limbs due to sacral nerve roots injury. Caring for patients after sacrectomy requires the orthopedic nurses to be well-informed about the disease process and its devastating impact on the neurological functioning of the patient. This case report focuses on sacral Schwannoma and the caring experiences for a patient with sacral amputation.
Keywords: case report, sacral Schwannoma, neurolemmoma, sacral tumor, sacral amputation, nursing care, lumbopelvic fixation

REFERENCES

SLEEP QUALITY AND PAIN INTENSITY AMONG ELDERLY PATIENTS UNDERGOING ORTHOPEDIC SURGERIES
* Nirmala M. Emmanuel, M.Sc (N), ** Vaishali Jaiswal, M.Sc., NET, *** Ritika Tiwari, M.B.A., *** Angela Gnanadurai, M.Sc (N)., Ph.D (N), **** Vernon N. Lee, D. Ortho, MS. Ortho, MCh. Ortho
* Associate Professor, College of Nursing, CMC, Vellore, ** Professor, College of Nursing, CMC, Vellore, *** Professor, Jubilee Mission College of Nursing, Thrissur, Kerala, **** Emeritus Professor, Dept. of Orthopedics, CMC, Vellore
ABSTRACT
Comfort is a basic physiological need of a human being. The need for rest and comfort is important for maintaining a good quality of life. Good sleep and absence of pain provide comfort for an individual. Pain is a subjective feeling which is individualized and difficult to define. People try to cope with chronic pain due to the prolonged duration, but acute pain seems to be threatening to all. Postoperative pain especially is unbearable. Postoperative pain management poses a great challenge to the nurses even with newer more effective management. This study used a descriptive correlational design to assess the relationship between sleep quality and pain intensity among the elderly patients undergoing orthopedic surgeries. A purposive sampling technique was used to recruit 30 subjects consisting of male and female elderly patients above the age of 60 years who had undergone orthopaedic surgeries of the lower limbs such as joint replacement, throplasty, internal and external fixations, and debridement of bone. Sleep quality and pain intensity were assessed using scales such as Groningen Sleep Quality Scale and Numerical Rating scale respectively. Descriptive and inferential statistics were used to analyse the data. The results revealed that a larger number of subjects had good sleep (43.3%) and moderate pain (63.3%). There was a highly negative correlation between sleep quality and pain intensity (r = -.677) with milder pain associated with better sleep quality. This study highlighted the need for regular assessment of pain and sleep and the introduction of measures to promote sleep among the institutionalized elders. Increased research is required in management of pain and promotion of sleep in the elderly patients in order to improve their quality of life.

Keywords: sleep quality, pain intensity, elderly, orthopedic surgeries, correlation
REFERENCES

EFFECTIVENESS OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE OF ANGANWADI WORKERS REGARDING MENTAL HEALTH AND ITS PROBLEMS IN CHILDREN
* Dhanya M. Sebastian, M.Sc (N), ** Dorothy D. Theodore, M.Sc (N)., Ph. D (N)
* Lecturer, St. Joseph’s College of Nursing, Kothamangalam, Kerala, ** Principal, Narayana Hrudalaya College of Nursing, Bengaluru
ABSTRACT
Lack of adequate professionals to meet the mental health needs of Indian society has triggered the researchers in identifying Anganwadi workers as potential primary mental healthcare providers for toddlers and preschoolers. This is an experimental study to assess the effectiveness of a structured teaching programme on the knowledge of Anganwadi workers regarding mental health promotion and early identification of mental illness among toddlers and preschoolers. The research approach used for the study was a true experimental design. Pretest posttest control group design was adopted for the present study. Researcher used simple random sampling using sampling frame made from the list of Anganwadi workers of Anekal Taluk. The subjects were 37 Anganwadi workers from experimental group and 37 from control group. The findings showed that in the posttest 83.8% had average knowledge and 16.2% had good knowledge in experimental group, where as in control group 87% had poor knowledge and 13.5% had average knowledge. The calculated paired ‘t’ value in the experimental group was -19.19 which was significant (p

Keywords: mental health, mental health promotion, identification of mental illness, toddlers, preschoolers, Anganwadi workers
REFERENCES

EFFECTIVENESS OF CHILDBIRTH PREPERATION ON ANXIETY AND SELF EFFICACY OF PRIMIGRAVID WOMEN
* Anu S. Kuruvilla, M.Sc (N), ** Christy Simpson, M.Sc (N)., PGDC., Ph. D(N), *** Nirmala Manoharan, M.Sc (N), **** Annie Regi, M.D (Obstetrics & Gynecology)
* Nursing Superintendent, Harriet Benson Memorial Hospital, Lalitpur, Uttar Pradesh, ** Professor, Christian Institute of Health Sciences, Dimapur, Nagaland, *** Professor, College of Nursing, CMC, Vellore, **** Professor, Dept.of Obstetrics and Gynecology, CMC, Vellore
ABSTRACT
Childbirth is a powerful event in the life of a woman. The experiences of women undergoing the process of childbirth differ from person to person. Childbirth preparation enables women to have a satisfactory experience by reducing their anxiety and enabling them to build confidence in undergoing the process of childbirth. A quasi experimental design was conducted to assess the effectiveness of childbirth preparation on anxiety and self efficacy among primigravid women. Convenience sampling was used to select a total of 80 subjects (40 each in experimental and control group). The subjects in the experimental group were provided a teaching session on childbirth preparation while control group subjects received standard care. Spielberger’s State Trait Anxiety scale and Labour Agentry scale were used to measure the anxiety and self efficacy of women during childbirth. Descriptive and inferential statistics were used for analysis. The results showed that the mean scores of anxiety in experimental and control group were 37.48 and 44.48 respectively while mean self efficacy scores were found to be 51.88 in experimental group and 45.80 in control group. The comparison of mean scores between both groups showed a significant difference (p

Keywords: childbirth, childbirth preparation, primigravid women, anxiety, self efficacy
REFERENCES

BURN MANAGEMENT : CHALLENGING ROLE OF BURN NURSES – PART I
* Beulah Premkumar, M.Sc (N)., M.A., M. Phil, ** Regina Xavier, M.Sc (N), *** Alice S. Kumar, M.Sc (N), **** Jabin Khaja, M.Sc (N), ***** Prasanna K. Sathiyanathan, M.Sc (N), ****** Harini Srinivasan, B.Sc (N), ******* Kalaivani Gnanamani, P.B.B.Sc(N)
* Professor, College of Nursing, CMC, Vellore, ** Professor, College of Nursing, CMC, Vellore, *** Professor, College of Nursing, CMC, Vellore, **** Associate Professor, College of Nursing, CMC, Vellore, ***** Junior Lecturer, College of Nursing, CMC, Vellore, ****** Tutor, College of Nursing, CMC, Vellore, ******* Charge Nurse, CMC, Vellore
ABSTRACT
Burn injury as an accident is prevailing from ancient time since people started using fire for fight, cooking, and hunting. The treatment for burns has a rich heritage from 1600 B.C, till the current century. The modern advancements in burn management are based on evidence as an outcome of research performed in the field of medical management. Thus the advancement in science and technology in the field of medicine has paved the way and the pace in the branch of plastic and reconstructive surgery and its related burn nursing. The development of burn nursing as a specialty has evolved to meet the need for specially trained nurses to provide comprehensive care to burn patients according to the changing trends in burn management. This article provides in-depth knowledge on burn management that includes first aid for burns, fluid resuscitation, nutritional management, wound management, pharmacological, and surgical management. The success of burn nursing is the coordination of the functions of the entire team members through multidisciplinary approach.

Keywords: burn, burn assessment, burn management, nurse’s role
REFERENCES

DRAVET SYNDROME : A CASE STUDY
* Honey Augustine, B.Sc (N), ** Ibamedari Warbah, B.Sc (N), *** Deena Edwin, M.Sc (N)
* III Year Nursing Student, College of Nursing, CMC, Vellore, ** III Year Nursing Student, College of Nursing, CMC, Vellore, *** Junior Lecturer, College of Nursing, CMC, Vellore
ABSTRACT
Dravet syndrome, also known as Severe Myoclonic Epilepsy of Infancy (SMEI), is a rare and catastrophic form of intractable epilepsy that begins in infancy. Initial seizures are most often prolonged events and in the second year of life other seizure types begin to emerge. Unless a cure or better treatments for Dravet syndrome is found, individuals with this disorder face a diminished quality of life. Current treatment options are extremely limited. The constant care and supervision of an individual with highly specialized needs is emotionally and financially draining on the family members/guardians who care for them. Nursing management of these patients is a major challenge and nurses require good counseling skills. This article focuses on the nursing care of a patient with Dravet syndrome and using nursing process approach, a case study is presented.

Keywords: Dravet syndrome, myoclonic epilepsy, seizures, nursing care, case study, interactable epilepsy, infantile onset epilepsy
REFERENCES
Arzimanoglou, A., Guerrini, R., & Aicardi, J. (2004). Aicardi’s epilepsy in children. New York: Lippincott Williams & Wilkins.

EFEECTIVENESS OF A PLANNED TEACHING PROGRAM ON KNOWLEDGE AND SKILLS REGARDING COMMUNICATION AMONG ADOLESCENTS
* Kenneth S. Guddeti, M.Sc (N), ** Dorothy D. Theodore, M.Sc (N), Ph.D
* Assistant Professor, Metas Adventist College of Nursing, Nuzvid, ** Principal, Narayana Hrudhayalaya College of Nursing, Bengaluru
ABSTRACT
Communication is an inevitable process in everyone’s life, more so when it comes to adolescents. It is an integral part of their overall development. Present study was done to assess the effectiveness of a planned teaching program on knowledge and skills regarding communication among high school students. The research method used was a true experimental approach with pretest, posttest control group design; sixty adolescents were selected using simple random sampling technique from a sample frame of 90 students in a selected government school in Anekal taluk of Bangalore. Investigator – prepared knowledge and skill questionnaire were used for data collection. One day workshop with sessions including interpersonal communication skills, public speaking skills, assertive training, speaking skills, writing skills, and reading skills was conducted. The findings revealed that the participants in the experimental group showed improvement in knowledge (t=7.66, p=.05) and skills (t=5.81, p=.05) regarding communication compared to the control group.

Keywords: high school students, adolescents, communication, communication skill, teaching program
REFERENCES

PERCEIVED STIGMA AND QUALITY OF LIFE AMONG TRANSGENDERS
* Nanzy F. M, M.Sc (N), **Rogina J. S. Savarimuthu, M.Sc (N).,
M.Sc (Psychology)., M.Sc (Psychotherapy & Counselling)
* M.Sc Nursing Student (at the time of submission) Matha College of Nursing, Manamadurai, ** Reader (Former), Matha College of Nursing, Manamadurai
ABSTRACT
A quantitative study was conducted among transgenders living in Madurai district, South India to assess the level of perceived stigma and quality of life. A descriptive research design was used. Snowball sampling was used to select the sample. Data were collected using transgender stigma questionnaire and World Health Organization quality of life BREF scale. Analysis revealed that transgerders experienced stigma with majority of them experiencing severe (23.3%) to moderate (50%) level. Majority of them had low (20%) to moderate (60%) quality of life. Negative correlation (r = -.38) was found between perceived stigma and quality of life. Educational status (p=.01) and occupation (p=.02) were significantly associated with perceived stigma (p=.04). Occupation was significantly associated with low quality of life. Further studies are needed to generalize the findings. Nurses should be aware that perception of stigma in transgenders can influence their quality of life.

Keywords: stigma, perceived stigma, quality of life, transgenders
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