IJCNE: JUL–DEC 2013, VOL 14, NO 2

IJCNE Journal

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Editorial
Ethics in Scientific Writing: Preventing Plagiarism 2 (Punitha Ezhilarasu)

Concepts and Issues
Nurses as Policy Makers 11 (Bhasura Chandrachood)
Conceptual Framework: A Road Map for Nursing Research 15 (Dorothy D. Theodore)

Clinical Article
Pleomorphic Adenoma of the Salivary Gland: A Case Report 23 (Shalini Chandran, Nirmala M. Emmanuel, Jothi P. Nixon)

Research Article
Utilization, Satisfaction, and Perception on Use of Complementary and Alternative Medicine Therapies among Nurses 29 (Jaslina Gnanarani, Latha Venkatesan, Nicola S. Ambrose, Pappy Yuvarani Elizabeth J. Abraham, Punitha Ezhilarasu)

Research Series No.10
Ethics in Nursing Research 41 (Premila Lee)

Continuing Education Series No: 25
Superior Mesenteric Artery Syndrome 45 (Emily S. Daniel, Angeline Esther, Hannah Jayaseeli, Shirley David)

Student Section
Application of Neuman Systems Model 57 (Eswari George, Bala Seetharaman, Anandharuby Jacob)

Research in Brief
Menopausal Symptoms and Severity among Premenopausal Women 35 Effectiveness of Structured Teaching on Knowledge, Attitude, and Practice of Mothers Regarding Diarrhoea 65 (Deena Edwin, Bharathy Jacob, Mary A. Johnson, Kala Ebenezer)
Group versus Individual Diabetic Education among Patients with Type 2 Diabetes Mellitus 69 (Sumathy Jayaraman, Jayarani Premkumar, Beulah Premkumar, Nihal Thomas)
Obstetric Morbidities and Treatment Seeking Behaviour among Pregnant Women 73 (Mamta, Sushma K. Saini)

Abstracts

NURSES AS POLICY MAKERS
*Bhasura Chandrachood, M. Sc (N)
*Professor, College of Nursing, Benziger Hospital, Kollam, Kerala
ABSTRACT
Registered nurses represent the single largest health care providers. They occupy varied positions in all areas of health care which give them a unique opportunity to contribute to policy making related to patient care, nursing education, management, and research. Although nurses’ involvement in policy making related to patient care is recognized, their contribution to policy making related to research and overall health is minimal. Qualified nurses should be appointed at key leadership positions in government industry, health related foundations and consumer organizations to strengthen their involvement in health and nursing related policy formulation and planning. This article highlights the need for nurses to be involved in policy making relevant to health and nursing. The current scenario of their involvement, the barriers and methods to overcome them, nurses’ involvement in legislative process, role of regulatory bodies, education and research, and national nursing policy are also presented.

Key words: nurse, policy making, leadership, health care, policy
REFERENCES

  • Blais, K., Hayes, J., Kozier, B., & Erb, G. (2001). Professional nursing practice: Concepts and perspectives (5th ed.). London: Prentice Hall.
  • Dickson, G. L., & Flynn, L. (2008). Nursing policy research:Turning evidence based research in to healthy policy. New York: Library of Congress Cataloging-in-Publication.
  • Khoury, C. M., Blizzard, R., Moore, L. W., & Hassmiller, S. (2011). Nursing leadership from bedside to boardroom: A Gallup national survey of opinion leaders. The Journal of Nursing Administration, 41(7/8), 299-305.
  • Kumar, D. (2005). Nursing for the delivery of health interventions. In L. G. Pranay (Ed.), Financing and delivery of health care services in India. New Delhi: Ministry of Health and Family Welfare, Government of India.
  • Mason, D. J., Leavitt, J. K., & Chaffe, M. (2002). Policy and politics in nursing and health care (4th ed.). Philadelphia: WB Saunders.
  • Trained Nurses Association of India. (2002). Policy and position statement. Retrieved from http://tnaionline.org/policy.htm
  • World Health Organization. (2002). Nursing and midwiferyservice – Strategic directions 2002-2008. Geneva: World Health Organization. Retrieved from http://www.who.int/hrh/nursing_midwifery/strategic_directions_en.pdf

CONCEPTUAL FRAMEWORK : A ROAD MAP FOR NURSING RESEARCH
*Dorothy D. Theodore, M. Sc (N)
*Principal, Narayana Hrudyalaya College of Nursing, Bangalore
ABSTRACT
The terms concepts, conceptual frameworks, theoretical frameworks, conceptual models, and theories are used interchangeably in nursing literature. However, they have subtle differences. The author has tried to clarify and differentiate the same in this article. Researchers find the aspects related to development or use of appropriate conceptual framework as a difficult step in the research process. Therefore, this article deals with the aim, purposes, components, formulation, and evaluation of a conceptual framework and its limitations.

Key Words: concept, framework, concept map, conceptual framework, theory
REFERENCES

  • Alligood, M. R., & Tomey, A. M. (2006). Nursing theory: Utilization and application (3rd ed.). St. Lous, Missouri: Elsevier Mosby.
  • Bordage, G. (2009). Conceptual frameworks to illuminate and magnify. Medical Education, 43, 312-319. doi:10.1111/j.1365-2923.2009.03295.x
  • Burns, N., & Grove, S. K. (2005). The practice of nursing research – Appraisal, synthesis and generation of evidence (5th ed.). Missouri: Saunders Elsevier.
  • Burns, N., & Grove, S. K. (2008). The practice of nursing research – Appraisal, synthesis and generation of evidence (6th ed.). Missouri: Saunders Elsevier.
  • Chinn, P. L., & Kramer, M. K. (1999). Theory and nursing: A systematic approach (5th ed.). St Louis: Mosby.
  • Fawcett. (2003). On bed baths and conceptual models of nursing. Journal of Advanced Nursing, 44, 229-230.
  • Maxwell. (2004). Conceptual framework – What do you think is going on. Retrieved from www.engin.umich.edu/…research…/maxwell-conceptual-framework
  • Meleis, A. I. (2007). Theoretical nursing development and progress (4th ed.). Philadelphia: Williams and Wilkins.
  • Miles, M. B., & Huberman, M. A. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Beverley Hills: Sage.
  • Nieswiadomy, R. M. (2008). Foundations of nursing research (6th ed.). India: Pearsons Education.
  • Smyth, R. (2004). Exploring the usefulness of a conceptual framework as a research tool: A researcher’s reflections. Issues in Educational Research, 14, 1-10.
  • Sturgeon, D. (2008). Skills for caring: Valuing knowledge of applied science in nursing. British Journal of Nursing, 17(5), 322-5.
  • Trafford, V., & Leshem, S. (2008). Stepping stones to achieving your doctorate. England: Mc Graw Hill International.
  • Vaughan, R. (2008). Conceptual framework. Retrieved from www.bournemouth.ac.uk ppt. Conceptual Framework: A Road Map for Nursing Research

PLEOMORPHIC ADENOMA OF THE SALIVARY GLAND : A CASE REPORT
*Shalini Chandran, M. Sc (N), ** Nirmala M. Emmanuel, M. Sc (N), *** Jothi P. Nixon, B. Sc (N)
* Lecturer, College of Nursing, CMC, Vellore, ** Reader, College of Nursing, CMC, Vellore, *** Tutor, College of Nursing, CMC, Vellore
ABSTRACT
Pleomorphic adenoma is the most common benign tumour of the major and minor salivary glands. It is predominantly found in the parotid glands. Pleomorphic adenoma presents as a single, painless, smooth, firm, lobulated, and mobile swelling in front of the parotid gland. When deep lobe is involved, it may not be manifested as a visible swelling in the preauricular region and is referred to as dumb bell tumour. Although the tumour is entirely benign, under exceptionally rare circumstances, an ordinary pleomorphic adenoma may metastasize to distant sites which too will have benign appearance as the original tumour. It is considered as a minor surgical condition; however, caring for patients with pleomorphic adenoma is a challenge for nurses as the tumour causes physical and psychological impact on the lives of the patients. This article outlines the disease process and its management. A case report is presented focusing on the nursing management of a patient with pleomorphic adenoma of the parotid gland, using nursing process.

Key Words: pleomorphic adenoma, salivary gland, parotidectomy, nursing care, case report, tumour
REFERENCES

  • Berjis, N., Okhovat, A., Baluchi, M., & Okhova, H. (2007). Complications and recurrence of parotid pleomorphic adenoma after partial parotidectomy at Alzahra hospital. Journal of Research in Medical Sciences, 12(1), 38-40.
  • Bhat, S. M. (2009). Manual of surgery (3rd ed.). New Delhi: Jaypee Brothers Medical Publishers.
  • Chahin, F. (2011). Salivary gland tumours, major, benign. Retrieved from http://emedicine.medscape.com/ article/194357-overview#a0102
  • Gurung, U., Shrestha, B. L., Sinha, B. K., & Baskota, D. K. (2010). Pleomorphic adenoma of salivary glands: An experience at Tribhuvan University Teaching Hospital. Nepalese Journal of ENT Head and Neck Surgery, 1(1), 8-11. Retrieved from www.solnepal.org.np/pdffiles/archive/12-15.pdf
  • Harsh, M. (2005). Text book of pathology (5th ed.). New Delhi: Jaypee Brothers Medical Publishers
  • Lazard, D. S., Baujat, B., Wagner, I., & Chabolle, F. (2005). Surgery in superficial-lobe pleomorphic parotid adenoma. Journal for Oto-Rhino-Laryngology, 87, 59-65. Retrieved from http://www.rforl.com/PDF/UK0508702.pdf
  • Smeltzer, S. C., & Bare, B. (2010). Brunner and Suddarth’s text book of medical surgical nursing (12th ed.). Philadelphia: Lippincott publication.
  • Thakur, J. S., Mohindroo, N. K., Mohindroo, S., Sharma, D. R., & Thakur, A. (2010). Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: A rare case report. BMC Ear Nose and Throat Disorder, 10(2). doi: 10.1186/1472-6815-10-2.
  • Tidy, C. (2011). Salivary gland tumours. Retrieved from http://www.patient.co.uk/doctor/Salivary-Gland- Tumours.htm
  • Tortora, G. J., & Derickson, B. (2006). Principles of anatomy and physiology (11th ed.). New Jersey: John Wiley & Sons.
  • Varghese, B. T., Sebastian, P., Abraham, E. K., & Mathews, A. (2003). Pleomorphic adenoma of minor salivary gland in the parapharyngeal space. World Journal of Surgical Oncology, 1, 2. Retrieved from http://www.wjso.com/content/1/1/2
  • Virtual Medical Centre. (2013). Gastrointestinal system. Retrieved from http://www.virtualmedicalcentre.com/anatomy/gastrointestinal-system/7#C4
  • Waugh, A., & Grant, A. (2010). Ross and Wilson anatomy and physiology in health and illness (11th ed.). Philadelphia Churchill Livingstone.
  • Weerakkody, Y., & Gaillard, F. (2013). Pleomorphic adenoma. Retrieved from http://radiopaedia.org/articles/pleomorphic_adenoma Pleomorphic Adenoma of the Salivary Gland: A Case Report

UTILIZATION , SATISFICATION AND PERCEPTION ON USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE THERAPIES AMONG NURSES
*Jaslina Gnanarani, M. Sc (N), **Latha Venkatesan, M. Sc (N)., Ph. D (N), *** Nicola S. Ambrose, M. Sc (N)
**** Pappy Yuvarani, M. Sc (N)
* Reader, Apollo College of Nursing, Chennai, ** Principal, Apollo College of Nursing, Chennai, *** Principal, Manjushree College of Nursing, Bangalore, **** Lecturer, Apollo College of Nursing, Chennai
ABSTRACT
Alternative and complementary medicine therapies are rooted in nursing history and many are derived from traditional nursing care approaches. Many studies have evaluated the effectiveness of individual therapies. The prevalence of Complementary and Alternative Medicine (CAM) therapies used by nurses has not been documented especially in the Indian context and this study explores the utilization, satisfaction, and perception of facilitators and barriers in the use of CAM therapies by the nurses. A descriptive research approach with a cross-sectional survey design was used and the sample included 241 nurses. A checklist for frequency and indications of use of CAM, a rating scale on satisfaction of nurses with the use of CAM therapies, and a semi structured opinionnaire on the perception of facilitators and barriers of using CAM were used to collect data. The participants reported that some of the most commonly used CAM by nurses for self and the patients were exercise (47.7%, 46.7%), massage (58.0%, 50.6%), deep breathing (66.4%, 59.4%), music (81.3%, 45.6%), prayer (83.4%, 49.5%), and muscle relaxation (31.9%, 38.6%) respectively. CAM use was reported to give a sense of control and was found to be cost effective. It could be used along with conventional medical treatment. Lack of awareness and acceptance by the lay community and health team were identified as some of the barriers to using CAM therapies.

Key Words: CAM therapies, utilization, purposes, perception, facilitators, barriers
REFERENCES

  • American Holistic Nurses’ Association. (2006). Position on the role of nurses in the practice of complementary and alternative therapies. Retrieved from http://www.aha.org/ about/statements.html
  • Astin, J. A. (1998). Why patients use alternative medicine: Results of a national study. The Journal of American Medical Association, 279(19), 1548- 53.
  • Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report, 10(12), 1-23.
  • Barnes, P. M., Powell-Griner, E., McFann, K., & Nahin, R. L. (2004). Complementary and alternative medicine use among adults: United States, 2002. Advance data from vital and health statistics, 343. Retrieved from http://www.cdc.gov /nchs/data/ad/ad343.pdf
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  • Hartfiel, N., Burton, C., Rycroft-Mabone, J., Clarke, G.,Havenhand, J., Khalsa, S. B., & Edwards, R. T. (2012). Yoga for reducing perceived stress and back pain at work. Occupational Medicine, 62(8), 606-12. Doi: 10.1093/occmed/kqs168. E pub 2012. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23012344
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  • Jain, N., & Astin, J. A. (2001). Barriers to acceptance: An exploratory study of complementary/alternative medicine disuse. Journal of Alternative and Complementary Medicine, 7(6), 689-96.
  • Lim, M. K., Sadarangani, P., Chan, H. L., & Heng, J. Y. (2005). Complementary and alternative medicine use in multiracial Singapore. Complementary Therapies in Medicine, 13, 16-24.
  • Mao, J. J., Farrar, J. T., Xie, S. X., Bowman, M. A., & Armstrong, K. (2007). Use of complementary and alternative medicine and prayer among a national sample of cancer survivors compared to other populations without cancer. Complementary Therapy Medicine,15(1), 21-9.
  • Nahin, R. L., Dahlhamer, J. M., Taylor, B. L., Barnes, R. M., Stussman, B. J., & Simile, C. M. (2007). Health behaviours and risk factors in those who use complementary and alternative medicine. BMC Public Health, 7(147), 217. National Center for Complementary and Alternative
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  • National Center for Complementary and Alternative Medicine. (2004). Expanding horizons of health care: Strategic plan 2005-2009. Retrieved from http://nccam.nih.gov/about/plans/ 2005
  • Ni, H., Simile, C., & Hardy, A. M. (2002). Utilization of complementary and alternative medicine by United States adults: Results from the 1999 national health interview survey. Medical Care, 40(4), 353-8. Retrieved from http://www.ncbi. nlm.nih.gov/pubmed/12021691?dopt=Citation
  • Rankin-Box, D. (2001). The nurses handbook of complementary therapies (2nd ed.). Edinburgh: Bailliere Tindall.
  • Saydah, S., H., & Eberhardt, M. S. (2006). Use of complementary and alternative medicine among adults with chronic diseases: United States, 2002. Journal of Alternative and Complementary Medicine, 12(8), 805-12.
  • Singh, V., Raidoo, D. M., & Harries, C. S. (2004). The prevalence, patterns of usage and people’s attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa. BMC Complementary and Alternative Medicine, 4(3). doi:10.1186/1472-6882-4.
  • Teresa, R. M., & Marcia, G. (2009). Complementary and alternative medicine: Oncology nurses’ knowledge and attitudes. Oncology Nursing Forum, 36(2). Retrieved from http://connection.ebscohost.com/c/articles/36858268/complementary-alternative-medicineoncology- nurses-knowledge-attitudes
  • To, K. (2009). Patient satisfaction concerning CAM discussion with primary care providers. Retrieved from kb.osu.edu/dspace/handle/1811/36985
  • Yates, J. S., Mustian, K. M., Morrow, G. R., Gillies, L. J., Padmanaban, D., Atkins, J. N., & Colman, L. K. (2005). Prevalence of complementary and alternative medicine use in cancer patients during treatment. Supportive care in cancer, 13(10), 806-11. Utilization, Satisfaction, and Perception on Use of CAM Therapies

MENOPAUSAL SYMPTOMS AND SEVERITY AMONG PREMENOPAUSAL WOMEN
* Elizabeth J. Abraham, M. Sc (N), ** Punitha Ezhilarasu, M. Sc (N)., Ph. D (N)
*Principal, PSG College of Nursing, Coimbatore, ** Professor, College of Nursing, CMC, Vellore
ABSTRACT
Traditionally premenopause has been under-recognized and untreated. Many Indian women are not aware of its symptoms or may mistake them for signs of other disorders. This study was undertaken to identify the menopausal symptoms among premenopausal women. Since India does not have specific health programs for women undergoing the menopausal transition, many women suffer silently and do not posses adequate skills and knowledge in dealing with specific symptoms related to menopause. A descriptive study was conducted to identify the menopausal symptoms using the standardized Menopausal Rating Scale (MRS). Two hundred women from 35 years to menopause were included in the study. Convenience sampling was used to select the subjects. The analysis of the symptoms experienced by the premenopausal women showed that hot flushes, anxiety, and physical and mental exhaustion were the most common symptoms experienced by the women while the least experienced symptoms were sleep disturbances and bladder problems. The results showed that 33.5% of the women were in the pre menopausal phase, 30.0% had mild symptoms, 20.0% had moderate symptoms, and 16.5 % had severe menopausal symptoms. The results indicated that the severity of the menopausal symptoms was related to the increasing age. Education and counseling done professionally and early in premenopause can ease women’s transition to menopause. This has a major implication for future nursing education and practice.

Key Words: menopause, premenopause, MRS, Menopausal Rating Scale
REFERENCES

  • Green, R., & Santoro, N. (2009). Menopausal symptoms and ethnicity: The study of women’s health across the nation. Women’s Health, 5(2), 127-33. doi: 10.2217/17455057.5.2.127
  • Gupta, P., Sturdee, D. W., & Hunter, M. S. (2006). Mid-age health in women from the Indian subcontinent (MAHWIS): General health and the experience of menopause in women. Climacteric, 9(1), 13-22. Retrieved from http: / / s e a r c h .proquest.com/docview/198749079?accountid=36116
  • Im, E., Liu, Y., Dormire, S., & Chee, W. (2008). Menopausal symptom experience: An online forum study. Journal of Advanced Nursing, 62(5), 541-550.
  • Isil, I. B., Ozcan, C., Eroglu, D., & Yanik, F. (2007). Quality of life and postmenopausal symptoms among women in a rural district of the capital city of turkey. Gynecological Endocrinology, 23(7), 404-9. Retrieved from http://search.proquest.com/docview/197446220?accountid=36116
  • Kaur, S., Walia, I., & Singh, A. (2004). How menopause affects the lives of women in suburban Chandigarh, India. Climacteric, 7(2), 175-80.
  • Lu, J., Liu, J., & Eden, J. (2007). The experience of menopausal symptoms by Arabic women in Sydney. Climacteric, 10(1), 72.
  • Ojeda, E., Monterrosa, A., Bluumel, J. E., Escobar-Loopez, J., & Chedraui, P. (2011). Severe menopausal symptoms in mid-aged Latin American women can be related to their indigenous ethnic component. Climacteric, 14(1), 157. Retrieved from http://search.proquest.com/docview/ 853597400? ccountid=36116
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  • Sudha, S., Vishal, R., & Annil, M. (2007). Menopausal symptoms in urban women. JK Science, 9(1), 13-17
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ETHICS IN NURSING RESEARCH
Premila Lee, M. Sc (N)., Ph. D (N)
Professor, College of Nursing, CMC, Vellore
ABSTRACT
In the beginning of twentieth century, research took place disregarding the rights of the study participants. This led to the evolvement of ethical guidelines. Researchers must pay special attention to the ethical issues and adhere to the ethical principles. It is the responsibility of the researcher to protect the study participants and their rights. This article highlights the historical background and discusses the ethical principles. The procedures to protect the study participants i.e., informed consent and the role of Institutional review board are presented.

Key Words: research ethics, ethical principles, Informed consent, Institutional Review Board, IRB
REFERENCES

  • Anderson, D. G., & Hatton, D. C. (2000). Issues in clinical nursing research. Western Journal of Nursing Research, 22(2). 244-51.
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  • Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1).
  • Gerrish, K., & Lacey, A. (Eds). (2010). The research process in nursing (6th ed.). United Kingdom: Wiley Blackwell.
  • Katz, K., & Garner, Z. (2012). Respecting human subject: Responsibilities of the clinical Investigator. In L. Bercovitch & C. Perlis (Eds.), Dermatuetics – Contemporary ethics and professionalism in dermatology (1st ed.). London: Springer.
  • Nieswiadomy, R. M. (2010). Foundations of nursing research (5th ed.). New Delhi: Pearson Education. Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
  • Rockwell, D. H., Yobs, A. R., & Moore, B. (1964). The Tuskegee study of untreated syphilis. Archives of Internal Medicine, 114(6), 792- 98.
  • Rothstein, W. G., & Phuong, L. H. (2007). Ethical attitudes of nurse, physician, and unaffiliated members of institutional review boards. Journal of Nursing Scholarship, 39(1), 79-85.

CONTINUING NURSING EDUCATION SERIES NO : 25 SUPERIOR MESENTERIC ARTERY SYNDROME
*Emily S. Daniel, M. Sc (N), ** Angelin Esther, M. Sc (N), *** Hannah Jayaseeli, B. Sc (N), **** Shirley David, M. Sc (N)
* Professor, College of Nursing, CMC, Vellore, ** Lecturer, College of Nursing, CMC, Vellore, *** Tutor, College of Nursing, CMC, Vellore, **** Professor, College of Nursing, CMC, Vellore
ABSTRACT
Superior Mesenteric Artery (SMA) syndrome is one of the rarest gastrointestinal disorders known to medical science, characterized by the vascular compression of the third part of duodenum, presenting as an uncommon cause of upper intestinal obstruction. SMA syndrome is triggered by any condition involving an insubstantial or insufficient cushion and narrow mesenteric angle. Symptoms are consistent with that of intestinal obstruction and diagnosis is often very difficult since it is very rare. Reversing or removing the precipitating factor is effective in managing symptoms in a patient with acute SMA syndrome. If the symptoms are refractory, surgical management is considered. The article describes the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and management of patients with SMA. The nursing management is discussed alongside an interesting case report of a 23 year old man with SMA who presented with severe malnutrition and was successfully managed.

Key Words: superior mesenteric artery syndrome, aorto-mesenteric angle, intestinal obstruction, nursing management
REFERENCES

  • Baltazar, B., Dunn, J., Floresguerra, C., Schmidt, L., Browder, W., & James H. (2000). Superior mesenteric artery syndrome: An uncommon cause of intestinal obstruction. South Medicine Journal, 93(6). Retrieved from http://www.medscape.com/viewarticle/410569.
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2007). Nursing care plans (7th ed.). New Delhi: Jaypee Publishers.
  • Karrer, F. M., & Jones, S. A. (2010). Superior mesenteric artery syndrome treatment & management. Retrieved from http://emedicine.medscape.com/article/932220-treatment#showall.
  • Kim, E. B., & Lee, T. H. (2013). Superior mesenteric artery syndrome: Past and present. Korean Journal of Medicine, 84(1), 28-36. Retrieved from http://synapse.koreamed.org/DOIx.php?id=10.3904/kjm.2013.84.1.28&vmode=PUBREADER
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  • Samdani, P. G., Samdani, V. & Geol, A. (2006). Superior mesenteric artery compression syndrome. Indian Journal of Peadiatrics, 73(6), 523-52.
  • Scovell, S. & Hamdan, A. (2012). Superior mesenteric artery syndrome – Anupdate. Retrieved from http://www.uptodate.com/contents/superiormesenteric-artery-syndrome
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  • Welsch, T., Büchler, M. W., & Kienle, P. (2007). Recalling superior mesenteric artery syndrome. Digestive surgery, 24, 149-156.

APPLICATION OF NEUMAN SYSTEMS MODEL
*Eswari George, B. Sc (N), **Bala Seetharaman, M. Sc (N), *** Anandharuby Jacob, M. Sc (N)
* M. Sc (N) Student, College of Nursing, CMC, Vellore, ** Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore
ABSTRACT
Neuman Systems Model is used commonly by the nurse practitioners and the nursing students while rendering comprehensive care to their clients with complex needs owing to its simplicity. The Neuman Systems Model provides a comprehensive, flexible, holistic, and systems-based perspective for nursing. In this model of nursing, Neuman focuses attention on the response of the person or the client system to actual or potential environmental stressors, and the use of primary, secondary, and tertiary nursing prevention interventions for retention, attainment, and maintenance of optimal client system wellness. The article describes the model and presents its application on a client focusing mainly on nursing assessment and intervention.

Key Words: Neuman System Model, concepts, metaparadigm, nursing assessment, stressor
REFERENCES

  • Alligood, M. R., & Tomey, A. M. (2010). Nursing theorists and their work (7th ed.). Maryland Heights, MO: Mosby Elsevier.
  • George, J. B. (2011). Nursing theories: The base for professional nursing practice (6th ed.). Upper Saddle River, New Jersey: Pearson Education.
  • Meleis, A. I. (2007). Theoretical nursing: Development and progress (4th ed.). Philadelphia: Lippincott Williams & Wilkins.
  • Parker, M. E. (2006). Nursing theories and nursing practice (2nd ed.). Philadelphia: F. A. Davis company. Application of Neuman Systems Model

EFFECTIVENESS OF STRUCTURED TEACHING ON KNOWLEDGE,ATTITUDE, AND PRACTICE OF MOTHERS REGARDING DIARRHOEA
*Deena Edwin, M. Sc (N), **Bharathy Jacob, M. Sc (N), *** Mary A. Johnson, M. Sc (N), ****Kala Ebenezer, MD., DCH
* Lecturer, College of Nursing, CMC, Vellore, ** Principal, College of Nursing, Christian Institute of Health Science and Research, Dimapur, ***Professor, College of Nursing, CMC, Vellore, ****Professor and Head, Paediatric Intensive Care Unit, CMC, Vellore
ABSTRACT
Diarrhoea continues to be an important cause of morbidity and mortality among young children in developing countries. As a disease that can easily be prevented or treated, diarrhoea related mortality can be reduced considerably, if parents are educated about the prevention of the disease and early treatment of dehydration. An experimental study was done in Christian Medical College, Vellore, to assess the effectiveness of a structured teaching programme (STP) on the knowledge, attitude and practice of mothers of children aged less than 5 years. One hundred and twenty six mothers were selected randomly and 63 of these mothers were given a STP using slides, video clips and pamphlets. The comparison of the post test scores in the experimental and the control group showed that there was significant improvement in the knowledge (p = .031), attitude (p = .002), and practice (p = .05) of mothers regarding diarrhoea. Therefore, a structured teaching is an important and effective tool for improving the parental management of diarrhoea in children.

Key Words: diarrhoea, structured teaching programme, knowledge, attitude, practice, under-five children
REFERENCES

  • Alrifai, S. B., Alsaadi, A., Mahmood, Y. A., Ali, A. A., & Al-Kaisi, L. A. (2009). Prevalence and etiology of nosocomial diarrhoea in children
  • Amin, S., & Bavafa, B. (2007). Iranian mothers child feeding practices during diarrhea. Pakistan Journal of Nutrition, 6, 217-219.
  • Bhattacharya, S., Biswas, R., & Saha, M. K. (1997). A study on impact of health education on rural mothers regarding oral rehydration therapy. Indian Journal of Public health, 42(4), 130-135.
  • Fayehun, O., & Omololu, O. (2008). Prevalence and treatment of childhood diarrhea among Nigerian ethnic groups. The Nigerian Journal of Sociology and Anthropology, 7, 14-28.
  • Gul, R., & Amin, R. (2011). Knowledge and perception of mothers and caregivers on childhood diarrhea and its management in Tanzania. Journal of Dow University, 5(3), 129-131.
  • Mangala, S., Gopinath, D., Narasimhamurthy, N. S, & Shivaram, C. (2001). Impact of educational intervention on knowledge of mothers regarding home management of diarrhea. Indian Journal of Pediatrics, 68(5), 393-397.
  • Mwambete, K. D., & Joseph, R. (2010). Knowledge and perception of mothers and caregivers on childhood diarrhea and its management in Temeke Municpality Tanzania. Tanzania Journal of Health Research, 12(1), 47-54.
  • Tobin, A. E., & Okojie, U. (2011). Assessment of knowledge on child feeding practices in South Nigeria, Nigeria Journal of Medicine, 1, 163-289.
  • United Nations. (2011). The Millennium development goals report. Retrieved from http://www.un.org/ millenniumgoals/ pdf/MDG%20 Report%202012.pdf
  • World Health Organization. (2012). Bulletin of WHO: India Facts and Statistics. Geneva: World Health Organization.
  • World Health Organization. (2013). Diarrhoeal disease. Retrieved from http://www.who.int/mediacentre/factsheets/fs330/en/

GROUP VERSUS INDIVIDUAL DIABETIC EDUCATION AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS
*Sumathy Jayaraman, M. Sc (N), **Jayarani Premkumar, M. Sc (N)., Ph. D (N),*** Beulah Premkumar, M. Sc (N), ****Nihal Thomas, MD., MNAMS., DNB., FRACP
*Lecturer, College of Nursing, CMC, Vellore, ** Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore, ****Professor, Dept of Endocrinology, CMC, Vellore
ABSTRACT
Diabetes self care management outcome is dependent on patient awareness and compliance with the recommended standards of care. Individual education demands a lot in terms of cost and professional time. A quasi experimental study was therefore conducted to determine the effect of group education versus individual education in terms of their knowledge and compliance to the treatment regimen among patients with type 2 diabetes attending the Endocrinology Out-Patient Department (OPD) in Christian Medical College, Vellore. Consecutive sampling technique was used to select the study subjects. Cluster randomization was used to assign the subjects to experimental and control groups. The pretest assessment was carried out using a knowledge questionnaire and compliance assessment tools for diet, drug, and exercise. A structured group or individual education was given to both groups respectively by the Investigator. The posttest assessment was conducted after seven days by the diabetes nurse educators in Endocrine OPD. The sample was skewed hence Mann-Whitney test was used. The association of demographic variables with knowledge and compliance to diet, drug, and exercise was analyzed using chi-square test. There was no significant difference (p = .295) in the knowledge and compliance related to diet, drug, and exercise between the two groups. Group education was found to be as effective as individual education.

Key Words: type 2 diabetes mellitus, compliance, individual education, group education, knowledge
REFERENCES

  • American Diabetes Association. (2004). Diabetes Care.Retrieved from http://care.diabetesjournals.org/content/29/suppl_1/s75.full
  • Duke, S. A., Colagiuri. S., & Colagiuri, R. (2009). Individual patient education for people with type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews, 21(1). Retrieved from http://www.ncbi. nlm.nih.gov/pubmed/19160249
  • Jenhani, M., Gaha, K., Nabouli, R., Ghedira, A., & Abdelaziz, A. (2005). Effectiveness of patient education on glycemic control in insulin treated patients in general practice. Diabetes and Metabolism, 31(4), 376-381. Retrieved from http://www.sciencedirect.com/science/article/pii/S1262363607702070
  • Mohan, V., Sandeep, S., Deepa, R., Shah, B., & Varghese, C. (2007). Epidemiology of type 2 diabetes: Indian scenario. The Indian Journal of Medical Research, 125, 217-230. Retrieved from http//www.icmr.nic.in/ijmr/2007/march
  • Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self reported measure of medication adherence. Medical care, 24(1), 67-74. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2562622/
  • Rickheim, P. L., Weaver, T. W., Flader, J. L., & Kendall, D. M. (2002). Assessment of group versus individual diabetes education. Diabetes Care, 25, 269-274.
  • Shaini, G. S., Venkatesan, L., & Ben, A. (2007). Effectiveness of structured teaching on homecare management of diabetes mellitus. Nursing Journal of India, 18(9).
  • University of Twente. (2013). Health beliefs model: Explaining health behaviors. Retrieved from http://www.tcw.utwente.nl/theorieenoverzicht/ theory.
  • World Health Organization. (2006). Diabetes. Retrieved from http//www.who.int/mediacentre/factsheets/fs312/en/

OBSTETRIC MORBIDITIES AND TREATMENT SEEKING BEHAVIOUR AMONG PREGNANT WOMEN
*Mamta, M. Sc (N), **Sushma K. Saini, M. Sc (N)., Ph. D (N)
*Lecturer, Silver Oaks College of Nursing, Punjab, **Lecturer, National Institute of Nursing Education, PGIMER, Chandigarh
ABSTRACT
Pregnancy is one of the important events in a woman’s life, but it can become dangerous to her life. A descriptive study was conducted in an Indian setting to determine the prevalence of obstetric morbidities and treatment seeking behaviour among pregnant women. One hundred pregnant women were randomly selected and interviewed with the help of a structured questionnaire and interview schedule. Majority of the subjects had either one or more health problem/s during pregnancy with comparable prevalence among primigravida and multigravida women (39% vs 38%). The most commonly reported morbidities were nutritional problems (56%) followed by back pain (34%), and anemia (16%). One fifth (20%) of the subjects with obstetric morbidities consulted doctors whereas 9% sought home remedies. Only 5 subjects were admitted to the hospital due to high fever, abdominal pain, hypertension, and seizures. There was a significant association between the educational status and treatment seeking behaviour with obstetric morbidities at p

Key Words: obstetric morbidities, pregnancy, treatment seeking behaviour, pregnant women
REFERENCES

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  • Shah, U., & Patel, R. (2008). Maternal morbidity in India. Retrieved http://prcbaroda.org/Pages/Maternal Morbidity.pdf