i-manager's Journal on Nursing (JNUR)


Volume 1 Issue 1 February - April 2011

Article

Heart Failure Nurse Case Management System: A rising need in Pakistan

Rozina Barolia*
*Senior Instructor, Aga Khan University School of Nursing.
Barolia, R. (2011). Heart Failure Nurse Case Management System: A rising need in Pakistan. i-manager’s Journal on Nursing, 1(1), 1-5. https://doi.org/10.26634/jnur.1.1.1358

Abstract

Heart failure is a complex and a debilitating syndrome (Driscoll, Worrall-Carte, Hare, Davidson, Riegel, Tonkin & Stewart, 2011) requiring complex management that places a significant burden on an individual, community and the health care system (McDonagh, 2005). However, cardiac patients in the third world including Pakistan, often suffer not only from the nature of their illness but also from the insufficiency of facilities available to treat them and to enhance their functional capabilities at work, home and in community than patients in more developed countries (Utriyaprasit & Moore, 2005). Therefore, concerted efforts are needed to manage heart failure patients in developing countries. Objective: This paper aims at elaborating the role of a nurse led case management program for heart failure patients in the light of literature within the context of Pakistan. Nurse led case management: Nursing case management is a dynamic and systematic collaborative approach to provide and coordinate health care services to a defined population (American Nurse Credentialing Centre). The nurse case manager is the coordinator of a multidisciplinary treatment plan which addresses a patient/ family’s continuum of care needs while ensuring clinical quality that is cost and time effective (White & Hall, 2006). As the complex nature of the disease requires holistic management, this approach provides patients with home visits, telephone calls, counseling sessions, support group and skills building. Conclusion: Nurse led case management should be introduced for the care of heart failure patients in Pakistan to improve quality and continuity of care, reducing length of hospital stay, improving pt satisfaction and assisting with the reduction in overall health care costs.

Article

Physical Activity factors for childhood overweight and obesity

Baby S. Nayak* , Vinod Bhat**
* Professor, Manipal College of Nursing, Manipal University, Udupi.
** Professor, Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal
Nayak, B.S., and Bhat, V. (2011). Physical Activity factors for childhood overweight and obesity. i-manager’s Journal on Nursing, 1(1), 6-10. https://doi.org/10.26634/jnur.1.1.1359

Abstract

Introduction: Overweight and obesity and their health consequences have been recognized as major public health problems worldwide. A significant increasing trend in the prevalence of overweight and obesity among children and adolescents has been documented over the last few decades in developed and in developing countries.  The present study attempted to identify the most common physical factors of childhood overweight and obesity.Methodology: A case control study was carried out among 310 obese (cases) and 384 non obese (control) children from selected schools of Udupi district.  Based on the BMI children were classified as obese or non-obese.  A structured questionnaire was administered to assess the physical activity level of the children.Result: The physical activity risk factors associated with childhood obesity are Less than two hours of physical education per week, sedentary activity after school hours, spending more than two hours per day in videogames and watching television, spending more than two hours per day on sedentary activity, never participating in team sports, less than two hours of vigorous physical activity per week, less than 3 sessions/week of muscle training activity. Conclusion: Sedentary lifestyle is the most common factor for childhood obesity. Measures should be initiated at the early age to prevent and control childhood obesity.

Article

Trends/issues faced by Health Care Professionals while Discussing Sexual Issues with patients

Nasreen Lalani* , Erum Jewani**, Saira Momin***, Anila Naveed****
* Senior Instructor, Aga Khan University
**,***,**** Aga Khan University.
Alwani, N., Jewani, E., Momin, S., and Naveed, A. (2011). Trends/issues faced by Health Care Professionals while Discussing Sexual Issues with patients. i-manager’s Journal on Nursing, 1(1), 11-16. https://doi.org/10.26634/jnur.1.1.1360

Abstract

Objective: The objective of the Literature Review Research is to investigate doctors and nurses’ perceptions on their roles and practices in meeting patients’ sexual health promotion needs. To identify the barriers of talking sexual health issues with patientsMethodology: A systematic search of the literature was performed for the period of January 1999 to 2009. A total 20 research articles were reviewed.Results: The literature review indicates that taking a sexual history is the first step towards appropriate diagnosis and therapeutic intervention for most patients, and is a fundamental part of holistic care. However, generally it is found from literatures that health care team members and patients feel hesitation in talking about sexual problems and concerns originated because of certain disease processes. The barriers identified included lack of time, lack of knowledge, personal attitudes about sexuality, and patient’s lack of readiness. Another barrier is the discomfort health care providers and patients may feel about discussing sexuality. Conclusion/recommendation: To accomplish the said objectives, the studies described attitudes and beliefs that might act as barriers to incorporating patient sexuality assessment and counseling into nursing / medical practice. The studies show that talking about sex-related topics is still repressed in patient—doctor encounters. It is an urgent matter to increase doctors/nurses awareness and clinical skills to deal with patients' sexual issues.

Research Paper

Sleep in the Fibromyalgia Patient

Linda Carol Hughes*
*Director of Undergraduate Nursing, Nebraska Methodist College.
Hughes, L.C. (2011). Sleep in the Fibromyalgia Patient. i-manager’s Journal on Nursing, 1(1), 17-23. https://doi.org/10.26634/jnur.1.1.1361

Abstract

It is estimated that fibromyalgia, a chronic condition in which pain occurs in 98% of the patients, can be found in 3-to 6- million American adults with females as the majority of those suffering. The aim of this study was to describe the relationship between sleep-wake disturbance (i.e. daily and mean number of awakenings each night, daily and mean percentage of sleep each night) and the daily and mean morning/evening intensity of chronic pain in a subset of women with fibromyalgia, based on daily actigraph recordings over seventy-two hours. Actigraph testing was completed on a convenience sample of 85 female participants, as part of a larger research study of 107 fibromyalgia patients. Results indicated significant associations between the evening intensity of pain, measured by a visual analog scale, and the night awakenings. The progressive association between the number of awakenings and pain should prompt further attention given to the sleep-wake disturbance in the fibromyalgia patient in the form of improved interventions directed to effective sleep.

Research Paper

Sleeping pattern and factors contributing to sleep disturbances among adults above 40 years residing in urban resettled colony of UT, Chandigarh

Jogindra Vati*
*Lecturer in Nursing, National Institute of Nursing Education, PGIMER, Chandigarh.
Vati, J. (2011). Sleeping pattern and factors contributing to sleep disturbances among adults above 40 years residing in urban resettled colony of UT, Chandigarh. i-manager’s Journal on Nursing, 1(1), 24-31. https://doi.org/10.26634/jnur.1.1.1362

Abstract

Background: Efficient functioning of people especially of elderly depends upon quality and quantity of sleep as well as the pattern of their sleep. Sleep efficiency shows a sharp decline among them. There is variation in factors which make them sleep as well as there are various factors that disturb their sleep. The studies conducted in India lacks about the details of sleeping pattern of the population above the age of 40 years.Objectives: To determine sleep and wake pattern of adults above 40 years residing in urban resettled colony and to identify and analyze the factors affecting their sleepMethods: A descriptive study was carried out on convenience sample of 222 adults above 40 years after getting the ethical clearance from ethical committee of Institute. A pre-tested semi-structured interview schedule was used to collect the data. Results: The subjects took on an average 37.6±44.9 minutes (range=0-300) to get into sleep. About 52(23.4%) faced difficulty to fell asleep. On the average they slept for 6±1.56 hours during night and had naps for 33.8±56.1 minutes during day time. The quality of sleep ranges from light sleep to very deep sleep. More than half of subjects woke up once or twice during night while 2 subjects were awake for more than six times. But majority of them were either alert (n=75) or fairly clear-headed (n=52) in the morning. Duration of night sleep decreased and day naps increased with advancement of age. Females had higher sleep latency and slept for longer time for longer time during night. The day naps and frequent awakening during night was common among males. Psychological and financial problems were the main factors for the disruption of their sleep. Implications: The study provides evidence on sleep patterns and contributing factors affecting the sleep patterns among adults above 40 years. Further studies can be conducted on impact of various measures to reduce the factors affecting the general quality of sleep, sleep onset, and sleep duration.

Research Paper

Win the battle of loneliness: Nurses Role

Kiran Qaisar Ali*
*Instructor, Aga Khan University School of Nursing, Karachi
Ali, K.Q. (2011). Win the battle of loneliness: Nurses Role. i-manager’s Journal on Nursing, 1(1), 32-37. https://doi.org/10.26634/jnur.1.1.1363

Abstract

Introduction: Loneliness is an emotional state of emptiness and hollowness. It has a great impact on physical and mental health of a person. As a health care professional, it is important and essential to prevent, detect and treat loneliness appropriately and effectively in order to promote mental health and prevent mental illnesses. Case Presentation: A 40 year old lady admitted in a psychiatric hospital with the diagnosis of schizophrenia a year back. There was no past and family history of psychiatric illness. Before her illness, she was leading a glorious life with her husband and children. When she was diagnosed as schizophrenic patient she had lost everything. Her husband got separated and at the same time he took their children with him. She was left all alone with her illness. Initially, there were lots of hurdles in interaction with this patient as she was not talking with anyone and remain isolated in her room. Whenever she speaks, she talks about her children. It seems that she was missing her children. One day during conversation, she stated that I feel emptiness. I am all alone in this world. Conclusion: To win the battle of loneliness, there are many ways to detect loneliness, however, clinical manifestation and patient’s history including root cause of loneliness plays a significant part. In addition, effective strategies could be applied by health care professionals as well as patients to combat with loneliness effectively.

Case Study

Meeting the social, emotional and psychological needs of patients in a cancer palliative care setting: Student Nurses’ experiences from Karachi, Pakistan

Nasreen Sulaiman Lalani* , Shabana D. Lakhani**, Muslim Shah***
* Senior Instructor, Aga Khan University School of Nursing, Karachi.
**,*** Post RN BScN student, Aga Khan University School of Nursing, Karachi.
Lalani, N.S., Lakhani, S.D., and Shah, M. (2011). Meeting the social, emotional and psychological needs of patients in a cancer palliative care setting: Student Nurses’ experiences from Karachi, Pakistan. i-manager’s Journal on Nursing, 1(1), 38-43. https://doi.org/10.26634/jnur.1.1.1364

Abstract

Palliative care is an urgent humanitarian need for people worldwide with cancer and other chronic fatal diseases as it provide comfort and ease suffering. Nearly 80 % of the cancer patients in Pakistan present late in stages 3 & 4 with terminal disease.  In Pakistan, the concept of palliative care is in its infancy stage and need to be strengthened.  In the early 1980s, the primary focus of palliative care was to provide pain and symptom relief. However, later the scope of palliative care was extended to take a holistic approach of care with a major emphasis on improving the quality of life of patients and their families or caregivers in general. This paper intent to share palliative care experiences where the student nurses from a teaching hospital under their faculty supervision utilized palliative care principles while giving holistic care to their patients in a hospice care setting. These patients were in their end stages of cancer and were suffering from various physiological as well as psychosocial issues. Pain was the major concern among these patients, therefore, other than the pharmacological support for the pain relief, various non pharmacologic measures such as therapeutic communication, guided imagery, relaxation exercises, religious and other diversional activities were used with the patients and their families in order to ease their suffering, emotional distress and provide optimal comfort and support during the terminal stages of their illnesses. The outcomes were measured as lowered pain scores, patients’ verbalization of having positive attitude towards life, increased motivation, strong nurse patient relationship and enhanced participation in activities of daily living.