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Editorial
Theories to Develop Theories (Vinitha Ravindran)

Concepts and Issues
Reflective Journalling Practice in Nursing (Irene Light)
Mental Health of Refugees (Rogina J. S. Savarimuthu)

Clinical Article
Mitochondrial Respiratory Chain Disease: A Case Presentation (Jeyasutha Chokkian)

Research Article
Perceived Quality of Life and Coping in Parents of Children with Chronic Kidney Disease (Rajesh K. Kataria)
Knowledge and Attitude of Nursing Personnel Regarding Patient Safety (Esther Kanthi , Mary A. Johnson, Indira Agarwal)
Psychosocial Behaviour in Children after Selective Urological Surgeries (Ida S. Priyadarsini, Margaret Manoharan, John Mathai, Antonisami Belavendra)
Knowledge of Staff Nurses Regarding Neonatal Hypothermia and Effectiveness of Embrace Thermopod in Prevention of Hypothermia (Dhanamani, Ebenezer E. Benjamin, Anne Jarone)

Research Series No: 15
Conceptual Models and Theories: Developing a Research Framework (Beulah Premkumar, Shirley David, VinithaRavindran)

Continuing Education Series No: 32
Surgical Management of Thyroid Gland Disorders: Nursing Care (Irene George, Nirmala M. Emmanuel, Premila Lee, Esther G. Asirvatham, Beaula R. Jayasingh, Nicole Johnson)

Student Section
Perception and Practice of Patients with Heart Failure Regarding Salt and Fluid Intake (Deena M. Mathukutty, BalasaraswathiSeetharaman, Ida S. Priyadarsini)

Research in Brief
Knowledge and Practice of Intensive Care Unit Nurses on Intravenous Drug Administration (Angeline J. Kirubakaran, Amala R. Amirtham)
Peer Mentoring in Clinical Learning of Nursing Students (Baby Subramanian, Soni S. P. Johnson)
Knowledge of Antenatal Mothers on Effects of Malaria in Pregnancy (Anu J. Kutty, Binu Joe )

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Abstracts

Reflective Journaling Practice in Nursing
* Irin Light, M.Sc (N)., M.A (Psychology)., Ph.D (N)
* Principal, Dr.G. Sakunthala College of Nursing, Trichy
ABSTRACT
Reflective journaling is a tool in developing critical thought and reflection through clarifying concepts. It gives nurses the opportunity to define and express clinical experiences in their own words. This improves observation and descriptive skills. Each nurse should examine the personal thoughts and actions through reflective journaling. The two types – reflection on action and reflection in action will help nurses to improve professional competence. Reflection requires adequate knowledge and is necessary for self-evaluation. The skills helpful for reflection are self-awareness, description, critical analysis, synthesis, and evaluation.

Keywords: reflective journaling, reflective skills, Gibbs model of reflection
REFERENCES

Mental Health of Refugees
*Rogina J. S. Savarimuthu, M.Sc (N)., M.Sc (Psychology).,M.S (Psychotherapy &Counseling )., C.A.F.E.
*Associate Professor, Chettinad College of Nursing, Chennai
ABSTRACT
In today’s world there is a growing number of asylum seekers and refugees owing to conflicts and persecutions worldwide. Asylum seekers and refugees’ demographic characteristics, pre-flight and post-flight adversities, and challenges, influence their mental health and psychological well being. Studies report that majority of the refugees have no mental illness. They use their own resources and coping strategies to cope with considerable difficulties encountered in their country of origin, during migration, in their new host country, and in the asylum seeking process. Post-traumatic stress disorder, depression, anxiety, infectious diseases, co-morbidity of physical ill health such as malnutrition, continuation of symptoms and impairment, complications from injuries due to trauma, including torture and violence have been reported among asylum seekers and refugees. The mechanism involved in the cause of mental health problems are complex. The difference in language, culture, and specific stressors associated with mental health problems among refugees and asylum seekers pose a challenge to the existing mental health approach. Hence identifying problems in adaptation and undertaking mental health promotion, prevention or treatment interventions in a timely fashion is crucial. Nursing curriculum should include the care of asylum seekers and refugees. Nurses should be empowered in trans-cultural nursing especially in the care of asylum seekers and refugees.

Keywords: asylum seekers, refugees, mental health
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Mitochondrial Respiratory Chain Disease: A Case Presentation
*JeyasuthaChokkian, M.Sc (N)
*Assocaite Professor, Narayana Hrudayalaya CON, Bengaluru
ABSTRACT
Mitochondrial respiratory chain diseases are a clinically heterogeneous group of disorders caused by mutation of genes encoded by either nuclear DNA or mitochondrial DNA. It is an incurable disease. Most of the patients die due to progression of condition with majority of the body systems getting affected. Nurses play a vital role in providing supportive management to the patient. A case study is presented in this article. The patient’s clinical condition, diagnostic tests done, and management are compared with the book picture.

Keywords: mitochondrial respiratory chain disease, case study, nuclear DNA, mitochondrial DNA
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Perceived Quality of Life and Coping in Parents of Children with Chronic Kidney Disease
* Esther Kanthi, M.Sc (N)., M.B.A (Hosp Admin), **Mary A. Johnson, M.Sc.(N)., M.A (Pub Admin), ***Indira Agarwal, M.D (Paed), F.I.S.N (PaedNeph)
*Junior Lecturer, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Professor, Department of Paediatrics, CMC, Vellore
ABSTRACT
Chronic kidney disease (CKD) is a condition related to irreversible kidney damage that can progress to end-stage renal disease. It is a devastating disease that can cause considerable reduction in the quality of life. It may be difficult for the parents to cope with having a child with this disease. The aim of this study was to assess the parental perception of quality of life of children with CKD and their coping, the relationship between perceived quality of life and parental coping and its association with selected demographic and clinical variables of children with CKD attending paediatric nephrology clinic and paediatric surgery outpatient department. A descriptive design was used. eighty two parents who fulfilled the inclusion criteria were selected using total enumerative sampling method. PedsQLTM End stage Renal Disease Module was administered to assess the parental perception of quality of life and Coping Health Inventory for Parents was used to assess parental coping. The findings showed that most (35.4%) of the children had stage II CKD. Thirty nine percent of the parents perceived the quality of life of their children as moderate and 46.3% of the parents had good coping. The study revealed a significant positive correlation (r = .394, p = .0001) between parental perception of quality of life and parental coping. There was also a significant association between perceived quality of life and monthly family income (p = .001) and serum haemoglobin level of the child (p = .05). The findings suggest that CKD can considerably affect the quality of life in children. There is a need to educate the parents regarding the condition and suggest methods to cope better with the illness. There is also a need to train the staff to counsel the children and parents.

Keywords: parental perception, quality of life, chronic kidney disease, parental coping
REFERENCES

Psychosocial Behaviour in Children after Selective Urological Surgeries
* Ida S. Priyadarsini, M.Sc (N)., M.B.A, **Margaret Manoharan, M.Sc.(N), *** John Mathai, M.S., D.N.B., M.Ch (Paediatric Surgery), ****Antonisami Belavendra, Ph.D., F.R.S.S. F.S.M.S
*Junior Lecturer, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Professor, Paediatric Surgery, CMC, Vellore, ****Professor, Biostatistics, CMC, Vellore
ABSTRACT
Caring for children with surgical issues is multidimensional. Urological surgeries result in prolonged and repeated hospitalizations and presence of urinary diversions such as stoma alters the child’s psychosocial status. Therefore it is important for nurses to explore the psychosocial behaviour of such children to enhance child and family coping. A cross sectional descriptive study was done to assess the parental perception of psychosocial behaviour in children undergoing selective urological surgeries. Purposive sampling technique was used to select parents of 105 children between 2-16 years of age who underwent selective urological surgery attending the paediatric surgery out patient department or admitted in the ward. Data were collected using demographic and clinical profoma which included Indian Academy of Pediatrics growth chart and the Child Behaviour Check List from the Achenbach System of Empirically Based Assessments, University of Vermount, USA. The findings revealed that 20.7% of pre-school children and 9.61% of children in the schooler age group had behavioural problems as perceived by the parents. The highest behavioural problems were perceived in the aggressive domain (24.6%) in pre-schooler and in the social domain (13.6%) among the schooler age group. There was no significant difference in the psychosocial behaviour between the two age groups. No significant association was found between the demographic, clinical variables, and psychosocial behaviour. Children after urological surgeries need to be followed for psychosocial behavioural changes. It is important for nurses to address these concerns and educate the parents on coping strategies to help the child and family to cope.

Keywords: psychosocial behaviour, selective urological surgeries, parents, children
REFERENCES

Knowledge of Staff Nurses regarding Neonatal Hypothermia and Effectiveness of Embrace Thermopod in Prevention of Hypothermia
* Dhanamani, M.Sc (N), ** Ebenezer E. Benjamin, M.Sc (N), ***Anne Jarone, M.Sc (N)
*Tutor, CSI Kalyani College of Nursing, Chennai, **Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore
ABSTRACT
Hypothermia is one of the main causes of neonatal mortality. Temperature of the environment during delivery and the postnatal period has a significant effect on the baby’s survival. The health professionals must be aware of the risk of falling body temperature immediately after birth. The main objective of this study was to assess the knowledge of staff nurses regarding neonatal hypothermia and effectiveness of Embrace thermopod in prevention of hypothermia among the babies born by Cesarean section in a tertiary care centre in South India. An experimental study design was used for the study. Data were collected from 73 staff nurses working in maternity wards and operating room who were recruited for the study by consecutive sampling technique. The self-reported knowledge questionnaire was administered to assess their knowledge on neonatal hypothermia. A total of 112 babies born by cesarean section (elective) were selected by simple random sampling technique while consecutive sampling technique was used for those requiring emergency cesarean section. Subjects were then randomised into experimental and control group. Control group babies received standard care and experimental group babies received standard care along with application of thermopod. After the transfer to the ward, the baby’s body temperature was measured by axillary temperature using digital thermometer. The findings showed that knowledge of staff nurses on neonatal hypothermia was inadequate. There was statistically significant association between staff nurses knowledge and area of work. The mean difference of temperature between thermopod group and standard care group was highly significant (p

Keywords: hypothermia, embrace thermopod, knowledge, thermoregulation, cesarean section.
REFERENCES

Conceptual Models and Theories: Developing a Research Framework
* Beulah Premkumar, M.Sc (N)., M.Phil, ** Shirley David, M.Sc (N).,Ph.D (N), *** VinithaRavindran, M.Sc (N).,Ph.D (N)
*Professor, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore
ABSTRACT
Conceptual models and theories provide structure for research. Research without a theoretical base provides isolated information which may not be used or applied effectively. The challenge for nurse researchers is to identify a model or theory that would a best fit for their area of study interest. In this research series article the authors unravel the simple steps that can be followed in identifying, choosing, and applying the constructs and concepts in the models or theories to develop a research framework. A research framework guides the researcher in developing research questions, refining their hypotheses, selecting interventions, defining and measuring variables. Roy’s adaptation model and a study intending to assess the effectiveness of grief counseling on adaptation to spousal loss are used as an example in this article to depict the theory-research congruence.

Keywords: conceptual model, theory, research framework, Roy’s adaptation model, spousal loss, grief
REFERENCES

Surgical Management of Thyroid Gland Disorders: Nursing Care
*Irene George, B.Sc (N), **Nirmala M. Emmanuel, M.Sc (N), ***Premila Lee, M.Sc (N).,Ph.D (N), ****Esther G. Asirvatham, GNM, *****Beaula R. Jayasingh, P.B.B.Sc (N), ******Nicole Johnson, B.Sc (N)
*Staff Nurse, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore, ****Staff Nurse, CMC, Vellore, *****Staff Nurse, CMC, Vellore, ******Tutor, College of Nursing, CMC, Vellore
ABSTRACT
Thyroid gland dysfunction is present in a large number of the people. It is commonly seen in women and is sometimes associated with other endocrine problems. Dysfunction of the thyroid gland causes deranged metabolic functions of the body leading to altered energy levels in performing the daily tasks. Thyroid disorders should be identified at the earliest to prevent complications and to improve the physiological functions of the body. Majority of the disorders are associated with increase or decrease in the serum level of thyroid hormones. Enlargement of thyroid gland leads to respiratory distress, voice change, and dysphagia. It also causes body image disturbances in young patients. Though medications control the growth of the gland, surgery becomes an option to reduce the clinical effects of an enlarged gland. As thyroid is a highly vascular organ, precautions need to be taken before and after surgery to prevent hemorrhage. Nursing care involves preparation of the patient for surgery and meticulous postoperative care to prevent complications associated with the injury to parathyroid gland and laryngeal nerve. Early identification of complications will enable prompt management and improved quality of life of the patient. This article focuses on the various thyroid disorders, the clinical manifestations, assessment and diagnostic tests, the surgical management and the nursing care. The nursing care of patient undergoing thyroidectomy is discussed in detail.

Keywords: thyroid disorders, thyroid hormones, thyroidectomy, preoperative care, postoperative care
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Perception and Practice of Patients with Heart Failure Regarding Salt and Fluid Intake
* Deena M. Mathukutty,B.Sc (N), ** Balasaraswathi Seetharaman, M.Sc (N)., Ph.D (N) ***Ida S. Priyadarsini, M.Sc (N)., M.B.A
*IV year B.Sc(N) student, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Junior Lecturer, College of Nursing, CMC, Vellore
ABSTRACT
Heart failure is a major public health concern and there is a steady increase in the number of patients who suffer heart failure every year. Sodium and fluid restricted diet therapy plays a major role in enhancing the quality of life of these patients. It is essential for patients with heart failure to understand the role of diet therapy to enhance outcomes. A descriptive approach was used to assess the perception and practice of patients regarding salt and fluid intake. A total of 20 patients were selected by using total enumerative sampling for a period of one week. The data were collected by using sociodemographicproforma, a self-administered perception questionnaire, and a practice checklist prepared by the Investigator. The findings of the study revealed that all (100%) of the patients had positive perception about restricted salt and fluid intake. The study also revealed that 60% of the patients were compliant towards salt and fluid intake. Health care professionals need to emphasize on the importance of dietary restrictions and encourage patients to adhere to the diet therapy.

Keywords: heart failure, diet, fluid intake, perception, practice
REFERENCES

Knowledge & Practice of ICU Nurses on IV Drug Administration
*Angeline J. Kirubakaran, M.Sc (N), ** Amala R. Amirtham, M.Sc (N)
*Junior Lecturer, College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore
ABSTRACT
Intravenous drug administration is a clinical competency that is expected of every nurse. Intravenous therapy is the best method of administering drugs for critically ill patients. It is a necessary method of delivering lifesaving treatments with an immediate therapeutic effect. This study with a descriptive research design was undertaken to identify the knowledge and practice of nurses regarding administering intravenous drugs. A self-administered knowledge questionnaire and an observational check list prepared by the investigator were used to assess the knowledge and practice. Thirty observations and twenty five staff nurses were included in the study. Convenience sampling was used to select subjects. The knowledge assessment among staff nurses showed that 64% had adequate knowledge regarding intravenous drug administration. Compliance to nursing practice was 71.6% according to the drug administration protocol. There was no significant correlation between knowledge and years of experience among staff nurses. The results indicate that appropriate on going education on intravenous drug administration and regular audit and feedback on the practice is needed to enhance safe nursing practice.

Key words: intravenous drug administration, staff nurses, knowledge, practice
REFERENCES

Peer Mentoring in Clinical Learning of Nursing Students
* Baby Subramanian, M.Sc (N), ** Soni S. P. Johnson, M.Sc (N)
ABSTRACT
Peer to peer mentoring has been shown to promote professional and personal development. Peer mentoring in higher education is regarded as an effective intervention to ensure the success and retention of vulnerable students. The objective of the study was to develop senior nursing students as mentors for improving junior student’s performance in antenatal assessment. Quasi experimental one group posttest design was adopted for the study. Tool to assess the knowledge on antenatal history and assessment, checklist for assessing the skill in collecting antenatal history and performing antenatal assessment, tool to assess the antenatal assessment performance of mentees (Dreyfus scale incorporated for antenatal assessment performance) and mentorship effectiveness scale were used for collecting data. Final year nursing students were selected & trained as mentors for antenatal assessment and they trained and evaluated the 3rd year mentee nursing students who performed 10 antenatal assessment with the mentors. Mentees satisfaction of mentoring was obtained using Mentorship Effectiveness Scale. Mean scores in the first antenatal assessment was 67.13% as compared to 87.13% in the 5th assessment. The paired t test value (5.66 at p…

Keywords: Peer mentor, mentee, antenatal assessment, Dreyfus scale, Mentorship effectiveness scale.
REFERENCES

Knowledge of Antenatal Mothers on Effects of Malaria in Pregnancy
* Anu J. Kutty, M.Sc (N), **Binu Joe, M.Sc (N)
ABSTRACT
Endemic malaria is a common occurrence in India. Although pregnant women belong to one of the groups who face the highest risk from malaria, malaria in pregnancy is under- addressed in India. When a woman is pregnant her immunity level is reduced, thus making her more vulnerable to malaria and it leads to dangerous consequences for both mother and her child. A descriptive study was done to assess the knowledge on effects of malaria in pregnancy among 50 antenatal mothers. The results revealed that 44% of the participants were aged 21-25 years, were second gravida, 52% had high school education, 56% were housewives, 38% had income between Rs. 5001-7000, 92% had no history of malaria in the family, 36% had received information on effects of malaria in pregnancy and 56% of the mothers were from urban area. The analysis revealed that 68% of the mothers had poor knowledge and 32% had moderate knowledge regarding effects of malaria on pregnancy. Overall knowledge regarding effects of malaria on pregnancy in the study population was 37.44% with total mean and SD as 11.98.±2.62. This reveals that the knowledge of antenatal mothers regarding effects of malaria on pregnancy is poor. There was no significant association between knowledge and demographic variables such as age, gravida, educational status, employment status, monthly income of the family, history of malaria in family, previous sources of information and residential area.

Keywords: malaria in pregnancy, antenatal mothers, knowledge.
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