IJCNE: JUL–DEC 2011, VOL 12, NO 2

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Editorial
Maintaining the Integrity of Scientific Publication: Whose Responsibility?(Punitha Ezhilarasu)

Concepts and Issues
Depression in Patients with End Stage Renal Disease: A Literature Review (Jadhav Sonali T, Premila Lee)
Paradigms in Nursing Knowledge Development: Where are We?(Vinitha Ravindran)

Clinical Article
Body’s Response to Heat: Pathophysiology of Burns and Nursing Care(Meena Ganapathy)

Research Article
Effect of Back Strengthening Exercises on Low Back Pain among Nursing Students(Rejani Raveendran Nair, Fatima D’silva)

Research Series No.6
Non Experimental Research Designs(Premila Lee)

Continuing Education Series No: 21
Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Dermatological Nursing Challenge(Sheeba Rani, Anandha Ruby Jacob, Anbu S Kumar)

Student Section
Congenital Ichthyosis and Vitamin D Deficiency: A Case Study(Ranjitha Chacko, Sheela Durai)

Research in Brief
Occupational Exposure to Blood and Body Fluids among Nursing Students(Hardeep Kaur, Neena Vir Singh, Sukhpal Kaur)


Abstracts

DEPRESSION IN PATIENTS WITH END STAGE RENAL DISEASE: A LITERATURE REVIEW
* Jadhav Sonali T, M.Sc (N)
** Premila Lee, M.Sc (N)., Ph.D
ABSTRACT
Depression is a mental disorder characterized by loss of interest in activities. The biopsychosocial factors cause depression. It is common among people with chronic debilitating illnesses. This article presents the depression seen in patients with End Stage Renal Disease (ESRD). It highlights its prevalence, risk factors, assessment and management.

PARADIGMS IN NURSING KNOWLEDGE DEVELOPMENT: WHERE ARE WE?
* Vinitha Ravindran, M.Sc (N)., Ph.D
ABSTRACT
Positivism and interpretivism are two paradigms that have influenced knowledge development in nursing. Although paradigmatic influences in knowledge development are much discussed in western nursing literature, Indian nurse scholars have seldom been overt in expressing their paradigmatic stance. The nursing scenario in India suggests that our way of thinking has been restricted by the medical model and a narrow view based on positivism and post positivism has been adopted for knowledge generation and application. In this paper the ontology, epistemology, and methodology of positivism and interpretivism are explicated and a pluralistic approach for nursing knowledge development is suggested.

BODY’S RESPONSE TO HEAT: PATHOPHYSIOLOGY OF BURNS AND NURSING CARE
* Meena Ganapathy, M.Sc (N)., Ph.D
ABSTRACT
The key to success while caring for patients with burn injuries depends on the nurse’s clear understanding about how the body responds to heat, the alterations that happen to the normal anatomy and physiology of skin and the priority areas for delivering comprehensive nursing care. This article intends to give the readers a comprehensive view of the pathophysiology and nursing care related to burns.

EFFECT OF BACK STRENGTHENING EXERCISES ON LOW BACK PAIN AMONG NURSING STUDENTS
* Rejani Raveendran Nair, M. Sc (N)
** Fatima D’silva, M. Sc (N)
ABSTRACT
A quasi experimental study was carried out to determine the effectiveness of back strengthening exercises on low back pain and functional performance among nursing students from a selected college in Karnataka, South India. Among the 393 nursing students, 237 of them were identified to have mechanical low back pain and using the diagnostic checklist, the prevalence rate was found to be 60.3%. One group pre test, post test design was used for the study. Sixty students who met the inclusion criteria and gave their consent for the participation in the study were recruited for the back strengthening exercise intervention. The intervention was carried out daily for 30 minutes for a duration of 30 days. The severity of low back pain and functional performance before and after the intervention were assessed using the Numerical Pain Rating Scale and Modified Oswestry Low Back Pain Disability Questionnaire respectively. The study findings revealed that 129 (54%) students had mild low back pain and 108 (46%) had moderate low back pain. Majority of the students 145 (61%) had minimal disability where as 92 (39%) had moderate disability. Majority of the students 120 (51%) expressed that performing activities of personal hygiene for patients was the main cause for low back pain. Back strengthening exercises were found to be effective in reducing low back pain and improving the functional performance among nursing students.

INTRA HOSPITAL TRANSPORTATION OF CRITICALLY ILL PATIENTS IN A SOUTH INDIAN TERTIARY MEDICAL CENTRE
* Abitha Ananda Soundariya, M.Sc (N)
** Punitha Ezhilarasu, M.Sc (N)., Ph.D
*** Angela Gnanadurai, M.Sc (N)., Ph.D
**** Mathew Joseph, MBBS., M.Ch (Neuro)
ABSTRACT
A descriptive observational study was undertaken to assess and explore the adequacy of the essential procedures being followed in the intra- hospital transportation of critically ill patients in the accident and emergency department and selected Intensive Care Units (ICUs) of a large tertiary medical centre. Pre-transport, in-transit (enroute), reception and infection control aspects of 36 transfers were studied using an observation checklist prepared by the investigator. The pre-transport and in-transit procedures were found to be adequate in 13.9% and 8.3% of transfers respectively. In 19.5% of transfers, the reception procedures on arrival were adequate. The in-transit procedures (91.7%) and infection control procedures (72.2%) were found to be inadequate. All the critically ill patients were escorted by a physician, hospital attendant and a family member. There was a significant difference (p=0.01) in oxygen saturation before and after transportation.

NON EXPERIMENTAL RESEARCH DESIGNS
* Premila Lee, M.Sc (N)., Ph.D
ABSTRACT
Research design is a blue print that enables the researcher to plan and implement the study. It is a challenge for the researcher to choose the appropriate design to produce the best possible evidence. Research designs can be broadly grouped under experimental and non-experimental designs. This article presents non experimental designs with examples under the classification of survey studies, relationship studies and developmental studies.

STEVENS – JOHNSON SYNDROME/TOXIC EPIDERMAL NECROLYSIS A DERMATOLOGICAL NURSING CHALLENGE
* Sheeba Rani, M. Sc (N)
** Anandha Ruby Jacob, M. Sc (N)
*** Anbu S Kumar, M. Sc (N)
ABSTRACT
Stevens – Johnson Syndrome and Toxic Epidermal Necrosis form a spectrum of rare, potentially debilitating conditions manifesting widespread epidermal loss with the involvement of mucous membranes. In most cases, it can be attributed to a drug reaction. It requires prolonged hospitalization and has significant complications which are fatal if not identified and treated promptly. Medical management aims at reducing complications and providing supportive therapy. Nursing management focuses on careful ongoing assessment and meticulous interventions towards the outcome of the illness. This article discusses the two clinical conditions, their management, complications and prognosis. The challenge of the nurse is highlighted with the main focus on helping the patient to avoid discomfort, systemic illness or death.

CONGENITAL ICHTHYOSIS AND VITAMIN D DEFICIENCY: A CASE STUDY
* Ranjitha Chacko, B.Sc (N)
** Sheela Durai, M.Sc (N)
ABSTRACT
Ichthyosis is a family of genetic skin disorders characterized by dry and scaly skin. Each year, more than 16,000 babies are born with some form of ichthyosis. Ichthyosis affects people of all ages, races and gender and can disturb them physically, psychologically and socially. Care of such patients and family requires collaboration with various members of the health team. Nurses can play a pivotal role in the care and rehabilitation of patients with ichthyosis and related complications. A case study is presented in this article. The patient’s clinical presentation, diagnosis and management are compared with the book picture. The nursing management of a patient presenting with complications is discussed in detail.

OCCUPATIONAL EXPOSURE TO BLOOD AND BODY FLUIDS AMONG NURSING STUDENTS
* Hardeep Kaur, B.Sc (N)
** Neena Vir Singh, M.Sc (N)
*** Sukhpal Kaur, M.Sc (N), Ph.D
ABSTRACT
A descriptive study was undertaken with the objective to estimate the incidence of occupational exposure to blood and body fluids among the nursing students. Selected factors related to the exposure were also studied. A total of 46 B.Sc. nursing interns were included in the study. A structured questionnaire was developed and validated to determine the occupational exposure to blood and body fluids experienced by the subjects in the preceding one year. The results revealed that the incidence of exposure was 744.49 per 100 nursing interns per year. Needle stick injuries were the most common mode of such exposures and the majority of the exposure was at the time of recapping of needles (69.6%). Approximately, three quarters of the occupational exposures occurred in the Emergency and Clean Labour Room. Majority (82.6%) reported that the factor most responsible was lack of personal protective equipment i.e. gloves, gown and mask. Only 52.2% of the affected subjects reported the occurrence of every exposure to the nursing staff on duty and 41.3% of them did not contact anyone. Majority of the subjects (78.2 %) were vaccinated against Hepatitis B.