IJCNE: JUL–DEC 2015, VOL 16, NO 2

IJCNE Journal

Goto Abstract
Editorial
Celebrating 15 Years: Cheers to Editorial Team (2000 – 2015) – (Punitha Ezhilarasu)

Concepts and Issues
Empowerment of School Teachers on Adolescent Reproductive Health Education (Sr. Jaicy, Vathasala Sadan)

Clinical Article
Pompe Disease: A Rare Clinical Entity (Kavitha K)
Caring for a Patient with Moyamoya Disease: A Case Report (Priscilla R. Sam)

Research Article
Predictors of Anxiety and Depression among Postmenopausal Women (Nisha Mathew, Alice Sony, Rachel Chandy)
Effectiveness of Instructional Video on Preoperative Anxiety of Patients Undergoing Orthopedic Surgery (Deborah Paripoorani, Valliammal Babu, Poongodi K, Vino M. Cherian)
Effectiveness of Structured Educational Intervention on Knowledge, Attitude, and Practice of Self-management Strategies among People with Epilepsy (Ophelia M. Kharmujai, Rajeshwari Siva, Shandrila Immanuel, Maya M. Thomas)
A Mixed Method Research on Sleep, Fatigue, and Quality of Life among Patients Undergoing Hemodialysis: A Pilot Study (Rohini T, Punitha Ezhilarasu)

Research Series No.13
Research Instruments (Manoranjitham Sathiyaseelan)

Continuing Education Series No: 29
Burn Management: Challenging Roles of Burn Nurses – Part II (Beulah Premkumar, Regina Xavier, Alice S. Kumar, Jabin Khaja, Prasanna K. Sathiyanathan, Harini Srinivasan, Kalaivani Gnanamani)

Student Section
Challenges in Caring for a Burn Survivor (Neethu Thomas, Nirmala M. Emmanuel)

Research in Brief
Effectiveness of Subliminal Music Therapy on Improvement of Mental Wellbeing among PLWHIV (S. M. Jahir Hussain, Rogina. J. S. Savarimuthu)
Effectiveness of Bibliotherapy for Stress Reduction among Nursing Students: An Experimental Study (Chinchu Zacharias, Dorothy D. Theodore)

Abstracts

EMPOWERMENT OF SCHOOL TEACHERS ON ADOLESCENT REPRODUCTIVE HEALTH EDUCATION
*Sr. Jaicy, M. Sc (N)., Ph. D (N)
**Vathsala Sadan, M. Sc (N)., Ph. D (N)
*Assistant Professor, Caritas College of Nursing, Kottayam
**Professor, College of Nursing, CMC, Vellore
ABSTRACT
Today’s adolescents determine the social fabric, economic productivity, and reproductive health and wellbeing of nations throughout the world in the coming decades. Adolescence is the period between childhood and adulthood. It begins with the appearance of secondary sexual characteristics and continues until sexual maturity is complete. During this period rapid physical changes are accompanied by important psychological changes. Reproductive health is related to adolescent physical, psychological, and social integrity. While considering the settings to address the reproductive health needs and problems of adolescents, schools stand out as one of the important and most utilized settings because through the school we can reach out to almost all adolescents. Teachers can play an important role in this field because children are moving through their crucial time of development and becoming sexually mature while attending school. To do this role effectively, teachers have to be empowered on adolescent reproductive health education. The need for teacher empowerment, its methods, and curriculum are discussed in this article. A model for teacher empowerment is developed based on the teacher education model and is presented. Nurses play a vital role as information providers and trainers in the field.

Keywords: teacher empowerment, adolescent reproductive health education
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POMPE DISEASE : A RARE CLINICAL ENTITY
* Kavitha K, M. Sc (N)
* Associate Professor, Sri B.M. Patil Institute of Nursing Science, Bijapur
ABSTRACT
Genes control many aspects of the body, including production of important enzymes. Every gene in the body comes as a pair. One copy is passed on by the father and one by the mother. Changes to a normal DNA makeup can result in a defect, also called a mutation in the gene, which can cause the gene to function improperly. In Pompe disease and other similar disorders, a gene mutation causes a deficiency or malfunction of a necessary enzyme. The combination of Glucosidase Acid Alpha (GAA) genes inherited from both parents determines whether a person will be affected by Pompe disease. Although Pompe disease is very rare, it can run in families because it is inherited, meaning that it gets passed on to people through their parents. If someone is diagnosed with the disease, there is a risk that relatives may also have the disease or be carriers. It is particularly important to test siblings of an affected child. Hence genetic counseling plays an important role in care of child and their family members. A brief account of its etiology, pathogenesis, clinical features, diagnosis, and management is provided in this article. The nursing management including role of a nurse as a care coordinator is also discussed using exemplars.

Keywords: gene, GAA enzyme, Pompe disease, mutation, inheritance, autosomal recessive disease
REFERENCES

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CARING FOR A PATIENT WITH MOYAMOYA DISEASE : A CASE REPORT
*Priscilla R. Sam, M. Sc (N)
*Professor, College of Nursing, CMC, Vellore
ABSTRACT
Moyamoya disease is a rare cerebrovascular disorder that is characterized by progressive stenosis of distal portion of the internal carotid artery and its main branches. Moyamoya is a Japanese word for a “cloud of smoke” that depicts the appearance of collaterals as occlusion of the blood vessels occur due to stenosis. It mostly affects the younger age group and they develop signs and symptoms of transient ischemic attacks, seizures, infarction, and strokes. In children the disease is characterized by ischemic events compared to adults who develop haemorrhagic manifestations. Diagnosis is based on characteristic arteriographic appearance. Management is not very clear although revascularization techniques are being tried. The effects of multiple strokes in the lives of these individuals have a cumulative load in the quality of life. Therefore nurses have a great role to play in the management of patients during the acute as well as the rehabilitative phases. For a comprehensive understanding of the disease here is an article with the details of the disease such as epidemiology, etiology, pathophysiology, clinical manifestations, diagnostic measures, and the management presented along with a case report focusing on nursing management.
Keywords: Moyamoya disease, stroke, seizures, transient ischemic attack, nursing management
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PREDICTORS OF ANXIETY AND DEPRESSION AMONG POSTMENOPAUSAL WOMAN
*Nisha Mathew, M. Sc (N), **Alice Sony, M. Sc (N), ***Rachel Chandy, M.D., DGO
*Health Coordinator, Kendriya Vidyalaya, Mumbai, **Professor, College of Nursing, CMC, Vellore, ***Professor, Dept of Obstetrics & Gynaecology, CMC, Vellore
ABSTRACT
The concept of quality of life among postmenopausal women is a growing concern among health care professionals. A quantitative approach with descriptive design was undertaken to assess the predictors of anxiety and depression among postmenopausal women which have a negative effect on quality of life. A total of 200 postmenopausal women were selected using convenience sampling technique. Data were collected using Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale. The findings revealed that most of the subjects had anxiety (63%) and depression (52.5%). The predictors of anxiety and depression were found to be age, education, occupation, marital status, number of children, age at menarche, age at menopause, and duration of menopause. It necessitates the need to educate postmenopausal women and also that the challenging needs of these women be addressed and attended to.

Keywords: menopause, anxiety, depression, postmenopausal women
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EFFECTIVENESS OF INSTRUCTIONAL VIDEO ON PREOPERATIVE ANXIETY OF PATIENTS UNDERGOING ORTHOPEDIC SURGERY
*Deborah Paripoorani, M. Sc (N), **Valliammal Babu, M. Sc (N), ***Poongodi, K., M. Sc (N), ****Vino M. Cherian, D.Ortho., MS (Ortho), DNB
*Junior Lecturer (At the time of submission), College of Nursing, CMC, Vellore, **Professor, College of Nursing, CMC, Vellore, ***Professor (Rtd), College of Nursing, CMC, Vellore, ****Professor, Department of Orthopedics, CMC, Vellore
ABSTRACT
Anxiety is very common among patients undergoing orthopedic surgery. Adequate preoperative information reduces anxiety and enhances quick recovery of patients. Structured surgical orientation video has gained more attention as a mode of education facilitating information provision, possibly anxiolytic, and less costly than many other procedures. A quasi experimental study using a pre-test, post-test control group design was conducted to assess the effectiveness of video instruction about perioperative care on preoperative anxiety of patients undergoing orthopedic surgery in selected orthopedic wards of Christian Medical College, Vellore. Cluster randomization of the wards to the experimental and control group was done and 35 subjects in experimental and 35 in control group were selected by total enumeration technique. An instructional video was developed and validated with content validity index of .85. The intervention was carried out on the day before surgery for experimental group. Anxiety was measured using State-Trait Anxiety Inventory on the day before and after surgery. The post intervention anxiety score was significantly reduced in the experimental group (t = 2.07, p = .05) with a mean difference of 2.23 and increased in control group (t = -6.18, p .05). The preoperative anxiety of patients if intervened, significant reduction is possible. Structured video teaching is found to reduce anxiety in this study and can be recommended for regular preoperative education of patients undergoing orthopedic surgery.

Keywords: anxiety, preoperative teaching, surgical orientation video, perioperative care, orthopedic surgery
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EFFECTIVENESS OF STRUCTURED EDUCATIONAL INTERVENTION ON KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF-MANAGEMENT STRATEGIES AMONG PEOPLE WITH EPILEPSY
*Ophelia M. Kharmujai, M. Sc (N), **Rajeshwari Siva, M. Sc (N)., M. Phil, ***Shandrila Immanuel, M. Sc (N), ****Maya M. Thomas, M. D (Paediatrics)., D. M (Neurology)
*Public Health Nurse, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, **Professor, College of Nursing, CMC, Vellore, ***Professor, College of Nursing, CMC, Vellore, ****Professor, Department of Neurological Sciences, CMC, Vellore
ABSTRACT
In India, the prevalence of epilepsy is about 5.35/1000 and in Vellore it is 3.83/1000. People with epilepsy often have inadequate knowledge of the causes of epilepsy. Educational interventions have been associated with improvements in knowledge, seizure outcomes and coping among people with epilepsy. The main objective of the study was to assess and compare the knowledge, attitude and practice on self-management strategies among people with epilepsy before and after the structured educational intervention. A quasi-experimental study design was used to interview 52 people with epilepsy on self-management strategies of epilepsy with a semi-structured questionnaire and an attitude scale before and after a structured educational intervention using multimedia presentation. A booklet on self-management strategies was also given to the study subjects. Descriptive and inferential statistics were used to analyze the data. The pre-test knowledge of self-management strategies of all people with epilepsy in the study is inadequate compared to 51(98.1%) in the post-test. In the pre-test, 15 (28.8%) people with epilepsy had favourable attitude compared to 18 (34.6%) in the post-test and 30(57.7%) people with epilepsy in the pre-test had adequate practice compared to 40 (76.9%) in the post-test. There were statistically significant increase in knowledge (p

Keywords: epilepsy, self management, strategies, structured educational intervention
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  • Walker, E. R., Bamps, Y., Burdett, A., Rothkoff, J., & Dilorio, C. (2012). Social support for self-management behaviors among people with epilepsy: A content analysis of the WebEase program. Epilepsy and Behaviour, 23 (3). doi:http://dx.doi.org/10.1016/j.yebeh.2012.01.006
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A MIXED METHOD RESEARCH ON SLEEP,FATIGUE AND QUALITY OF LIFE AMONG PATIENTS UNDERGOING HEMODIALYSIS : A PILOT STUDY
*Rohini T, M. Sc (N)., Ph.D (N)
**Punitha Ezhilarasu, M.Sc (N)., Ph.D (N)
*Associate Professor, Samaritan College of Nursing, Ernakulam
**Professor, College of Nursing, CMC, Vellore
ABSTRACT
The aim of the pilot study was to analyze the concepts related to sleep, fatigue, and quality of life (QOL) among patients undergoing hemodialysis and to assess the effect of Cognitive Behvioural Therapy (CBT) on their sleep, fatigue, and QOL in a selected hospital at Kerala. The design was an inductive phenomenological concept analysis of three semi structured interviews. The two group pre-test post-test control group design was tested specifically to increase the outcomes in a proposed larger study. Using van Manen’s concept analysis, the concepts related to sleep disturbances, fatigue, and QOL were identified. For the interventional study, group randomization was done to allocate the subjects to experimental and control group. The sample size included 10 in experimental group and 10 in control group. Group CBT was administered for about 40 to 60 minutes to subjects in experimental group for 4 weeks (twice weekly). Post assessment was done at 2 weeks, 6 weeks, and 10 weeks after the 8 session. Repeated measure ANOVA demonstrated the mean difference for sleep, fatigue, and QOL as significant between the groups (p

Keywords: sleep disturbance, fatigue, quality of life, cognitive behavioural therapy
REFERENCES

  • Adams, C., & van Manen, M. (2008). Phenomenology. In L. Given (Ed.), The SAGE encyclopedia of qualitative research methods (pp.615-620). Thousand Oaks, CA: SAGE publications.
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  • Rai, M., Rustagi, T., Rustagi, S., & Kohli, R. (2011). Depression, insomnia and sleep apnea in patients on maintenance hemodialysis. Indian Journal of Nephrology, 21(4), 223-229.
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RESEARCH INSTRUMENTS
* Manoranjitham Sathiyaseelan, M.Sc (N)., Ph.D
* Professor, College of Nursing, CMC, Vellore
ABSTRACT
The research instruments are the tools that the researcher uses to collect data. There are different types of instruments based on the structure or format, purpose, nature, and availability. The common types of instruments used in the nursing studies are questionnaires and scales. Instruments are selected based on the research question. The selection of instrument is a very important part of the research process and is lengthy and involving various steps. The credibility of an instrument depends on the validity and reliability. Whether, standardized or developed by the researcher, the validity and reliability has to be established before it is used.

Keywords: research instrument, validity, reliability
REFERENCES

  • Brink, P. J., & Wood, M. J. (1989). Advanced design in Nursing Research. Newbury Park, CA: Sage Publications
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  • Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. (9th ed.). London: Wolters & Kluwer.
  • Richard, M. J. (2013). Educational research: Instruments. Retrieved from www.83.homepage.villanova.edu/richard.jacobs/ on 27/06/2015
  • Tools of Research. (2015). Retrieved from http://www.mu.ac.in/myweb_test/Research%20Methadology-Paper-3/Chapter-9.pdf
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CHALLENGES IN CARING FOR A BURN SURVIVOR
*Neethu Thomas, B. Sc (N), **Nirmala M. Emmanuel, M. Sc (N)
*III year BSc (N) Student, College of Nursing, CMC, Vellore, **Associate Professor, College of Nursing, CMC, Vellore
ABSTRACT
Burns whether small or big, leaves a patient with increased nursing care demands to resume the normal or optimal living. Acute phase of burn provides more challenges regarding the physical care where as the rehabilitative phase requires more of psychological and social care. Throughout the period of recovery both in acute and rehabilitative phase a nurse needs to focus on the various dimensions of care such as physical, mental, social, and spiritual aspects to ensure a complete recovery of a patient with burns. This article presents the various challenges in caring for a burn survivor based on the nursing care demands such as physical, mental, and social health care needs and the nurses’ role in meeting these demands.

Keywords: burns, burn survivor, holistic health, nurses’ role, nursing care, challenges
REFERENCES

    Agbenorku, P. (2013). Burns functional disabilities among burn survivors: A study in KomfoAnokye teaching hospital, Ghana. International Journal of Burns and Trauma, 3(2). 78-86.
  • Alvi, T., Assad, F., Aurangzeb, & Malik, M. A. N. (2009). Anxiety and depression in burn patients. Journal of Ayub Medical College Abbottabad, 21(1), 137-141.
  • Blakeney, P., & Creson, D. (2002). Psychological and physical trauma: Treating the whole person. Journal of Mine Action. Retrieved from http://www.jmu.edu/cisr/journal/ 6.3/focus/blakeneyCreson/blakeneyCreson.htm
  • De Sousa, A., Sonavane, S., & Kurvey, A. (2013). Psychological issues in adult burn patients. Delhi Psychiatry Journal, 16(1), 24-33.
  • European Society for Traumatic Stress Studies. (2015). DSM IV PTSD definition. Retrieved from https://www.estss.org/learn-about-trauma/dsm-iv-definition/
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  • Model System Knowledge Translation System. (2011). Understanding and improving body image after burn injury. Retrieved from http://www.msktc.org/burn/factsheets/ Understanding-And-Improving-Body-Image-After-Burn-Injury
  • Noronha, D. O., & Faust, J. (2007). Identifying the variables impacting post-burn psychological adjustment: A metaanalysis. Journal of Paediatric Psychology, 32(3), 380-391.
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EFFECTIVENESS OF SUBLIMINAL MUSIC THERAPY ON IMPROVEMENT OF MENTAL WELLBEING AMONG PLWHIV
*S. M. Jahir Hussain, M. Sc (N), **Rogina J. S. Savarimuthu, M. Sc (N)., M. Sc (Psychology)., M. S. (Counseling & Psychotherapy)
*Nursing Tutor, College of Nursing, AIIMS, Uttarakhand, **Associate Professor (Former), Christian College of Nursing, Ambilikkai
ABSTRACT
People living with HIV (PLWHIV) experience severe psychosocial problems. PLWHIV experience depression, bipolar disorder, post traumatic stress disorder, anxiety and substance abuse. These mental health issues contribute to poor mental wellbeing. The study was conducted at the Community Care Center, Family Planning Association of India (FPAI), Hospital, Madurai. Quantitative pre-experimental research design and purposive sampling technique was utilized in the study. Sixty PLWHIV were included in the study. Instruments consist of demographic variables and the Warwick-Edinburgh Mental Well-Being Scale. Half (50%) of the study subjects reported below average mental wellbeing in the pre-test which decreased to 33.3% in the post-test. Average and good levels of mental wellbeing in post-test significantly improved following the subliminal music therapy. This reveals that subliminal music therapy can contribute to improved mental wellbeing among PLWHIV. Nurses can administer the subliminal music therapy for PLWHIV to improve their mental wellbeing.

Keywords: music therapy, subliminal music therapy, mental wellbeing, PLWHIV
REFERENCES

  • Brooks, J. S., Savoa, V., Allzen, E., Benedict, C., Fredriksson, R., & Schioth, B. H. (2012). Exposure to subliminal arousing stimuli induces robust activation in the amygdala, hippocampus, anterior cingulate, insular cortex and primary visual cortex: A systematic metaanalysis of MRI studies. NeuroImage, 59(3), 2962-2973. Retrieved from http://www.sciencedirect.com/science/article/pii/S1053811911011529
  • Choi, J. Y. (2013). Mental health of HIV-infected patients: A severe, but overlooked problem. Infection and Chemotherapy, 45(2), 239-240. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 24265974
  • Egermann, H., Kopiez, R., & Reuter, C. (2006). Is there an effect of subliminal messages in music on choice behavior? Journal of Articles in Support of the Null Hypothesis, 4(2), 1539- 8714. Retrieved from http://www.jasnh.com
  • Giorgio, L. (2014). Subliminal message research-unleash limitless power. Retrieved from www.deeptrancenow.com/subliminal_messages.htm
  • Guetin, S., Charras, K., Berard, A., Arbus, C., Berthelon, P., Blanc, F., . . . Leger, J. M. (2013). An overview of the use of music therapy in the context of Alzheimer’s disease: A report of a French expert group. Dementia, 12(5), 619-634. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 24337333
  • Lawrence, T. K. (2014). Subliminal therapy. Retrieved from http://www.subliminaltherapy.com
  • McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International Journal of Geriatric Psychiatry, 28(8), 781-794. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 23080214
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  • Simavli, S., Kaygusuz, I., Gumus, I., Usluogullarý, B., Yildirim, M., & Kafali, H. (2014). Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. Journal of Affective Disorders, 156, 194-199. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 24411681

EFFECTIVENESS OF BIBLIOTHERAPY FOR STRESS REDUCTION AMONG NURSING STUDENTS: AN EXPERIMENTAL STUDY
*Chinchu Zacharias, M. Sc (N), **Dorothy D. Theodore, M. Sc (N)., Ph. D (N)
*MSc Nursing Student (at the time of submission), Narayana Hrudayalaya College of Nursing, Bangalore, **Principal, Narayana Hrudayalaya College of Nursing, Bangalore
ABSTRACT
Stress experienced by nursing students is well documented, and is a result of multi-factorial aspects involving the cognition, emotion, and volition. Stress can adversely affect their performance. Bibliotherapy is found effective in the management of stress. Hence an experimental approach was used to assess the effectiveness of bibliotherapy in the management of stress experienced by nursing students in a selected college of nursing in Bangalore. A sample of 120 students who were randomly selected and assigned to the experimental and control groups participated in the study. The stress was measured using a standardized tool called ‘Student Nurses Stress Index’ which had a reliability score of Cronbach alpha of .7 when used among students in UK. The findings revealed that the groups matched in terms of the pretest stress scores. The independent “t” test was used to assess the effectiveness of bibliotherapy and the t value was 2.70 which was significant at

Keywords: effectiveness, bibliotherapy, stress reduction, nursing students
REFERENCES

  • Burnard, P., Edwards, D., Bennett, K., Tothova, V., Baldacchino, D., Bara, P., & Mytevelli, J. (2008). A comparative, longitudinal study of stress in student nurses in five countries: Albania, Brunei, the Czech Republic, Malta and Wales. Nurse Education Today, 28(2), 134-145.
  • Daise, J. (2011). Effectiveness of bibliotherapy on level of stress among senior citizens in selected old age homes in Bangalore (Unpublished master’s thesis). Rajiv Gandhi University of Health Science, Bangalore.
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  • Sreejesh, P. K. (2005). Effectiveness of bibliotheraphy on stress reduction among Hansen’s disease patients in selected settings in Mangalore (Unpublished master’s thesis). Rajiv Gandhi University of Health Science, Bangalore. Retrieved from www.rguhs.ac.in/cdc/onlinecdc/uploads/05_N036_1147.doc
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