Volume 5, Issue 5

Effect of Self-care Management Program on Self-efficacy among Patients with Colostomy
Original Research
Self-management program is vital for supporting, educating and improving patients’ self-efficacy with stoma. Aim of the study:was evaluated the effect of a self-care management program on self-efficacy of patients with colostomy. Hypothesis: self-management program had a positive effect on self-efficacy among patients with colostomy. Design: Quasi-experimental research design was used. Setting: The study was conducted at Benha Teaching Hospital, oncology unit in the general surgical department and outpatient Clinic.Subjects: A purposive sample of 30 patients from both genders. Tools: four tools were designed to collect data; stoma- related knowledge sheet, which was developed to assess Patients` knowledge about colostomy care. Self-care performance checklist, Ostomy Skin Tool to assess the extent and severity of peristomal skin complications and Stoma care self-Efficacy Scale.Results: mean score of age was 55.7± 8.56, 63.3% was mal, 80% was married, and 73.3% had bowel cancer. Mean score of total knowledge pre-program was 10.700±1.022, which increased to 24.70± 1.441 post program. 66.7% of patients had severe peristomal skin complications preprogram which decreased to 60% post program, while in follow up 56.7% of patients had mild peristomal skin complications. Related to stoma care self-efficacy there was statistical significant differences between three phases (p=.000). Conclusion: there was highly significant statistically improvement in all items of knowledge, practices and self-efficacy pre/post program of self-care management regarding colostomy patients. Recommendations:assessment of patients’ self-care performance during first six months after operation considered as evidence to his educational needs and concern.
American Journal of Nursing Research. 2017, 5(5), 191-199. DOI: 10.12691/ajnr-5-5-5
Pub. Date: October 28, 2017
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Empowering Mothers to Overcome Sickle Cell Crisis in Their Children through Engagement and Education
Original Research
Background: Sickle cell anemia is a common disease in Saudi Arabia. It causes major crises to children who suffering from it. Empowerment refers to measures designed, to increase autonomy and self-determination through professional support and engagement and empowerment. Mothers education and engagement are critical components of high-quality and early care of children suffering from sickle cell crises (SCC). Aims: To empower mothers to manage SCC events experienced by their children. To educate the mothers and engage them in caring for their children and to evaluate the effect of engagement and education on mother’s knowledge and performance regarding SCC. Study design: A quasi-experimental design was used. Individualized interview and small group teaching with pre and post evaluation was applied. Setting: The study was conducted in Pediatric Hematological Department at Maternity and Children Hospital, at Makkah Al-Mukararma. Subjects: A purposive sample composed of 40 mothers recruited according to certain inclusion and exclusion criteria. Tools:Two tools were used to collect data including, First: Interview Questionnaire sheet was used to collect mothers' socio-demographic characteristics. Second:empowerment scale, that consisted of 34 items within three construct areas family, services system and community. Results: Nearly two thirds of the mothers had poor knowledge regarding SCA pretest compared to one fifth of them posttest. Statistical significant differences regarding was found (P= 0.00). Improved mothers' performance was recognized post-test, most of the mothers, always give immunization, and enough oxygen. Three quarters of the mothers offer plenty of fluids to their children. Conclusion: Mothers knowledge and performance were improved after education and engagement. Mothers empowerment was very true “post-test” and there was statistical significant difference pre and posttest. There were significant positive correlations between mothers' age and their education, total knowledge, and total performance. Recommendations:Empowering and engaging mothers in caring for their children with SCA. Developing educational program for mothers about SCA and SCC.
American Journal of Nursing Research. 2017, 5(5), 182-190. DOI: 10.12691/ajnr-5-5-4
Pub. Date: October 25, 2017
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Risk Reduction Intervention for Osteoporosis and Osteoporotic Fracture among High-Risk People
Original Research
Introduction: Osteoporosis is a serious public health problem that currently causes global concern. Osteoporosis is a silent and potentially debilitating chronic illness that can cause fractures mostly in elderly. The National Osteoporosis Foundation (NOF; 2012) estimates that by 2025, osteoporosis will be the cause of 3 million fractures with an approximated healthcare expenditure of 25.3 billion dollars each year. In Egypt, the prevalence of osteoporosis in 2010 was 14.9% of the total population and it is projected to increase to 17.4% in 2020 and will further increase up to 30.3% by year 2050. Aim: to examine the effectiveness of risk reduction intervention for osteoporosis and osteoporotic fracture among high risk people. Methods: A quasi experimental design (study/control) was utilized. A convenience sample of Ninety subjects, who attended to the outpatient clinics, at Shebin El-Kom Menoufia University Hospital, Menuofia Governorate were selected. Data collection lasted six months from the beginning of September 2013 to May 2014. Tools: Fracture Risk Assessment Tool; Bone Mineral Density Test; General Practice Physical Activity Questionnaire, Calcium Food Calculator Questionnaire. Results: there was a statistical significant reduction of osteoporotic fracture risk score post intervention with mean score 5.16 ± 5.51. In the study group, 48 % of the participants were classified as moderately inactive which reduced to 28% post intervention. Also, approximately a quarter (23 %) of participants in the study group was inactive pre intervention compared with 8% post intervention. There was statistically significant improvement in total calcium intake post intervention compared with pre intervention. Conclusion: The risk reduction intervention was effective in improving bone health as indicated by the significant improvement in BMD score and the improvement of the mean score of fracture risk post intervention. Recommendations: Nurses in the primary health care centers should provide education to their patients about the need for good bone health as well as how to conduct good bone health with adequate calcium and vitamin D intake and moderate exercise with weight-bearing activities. They should also take time to provide health promotion in respect to osteoporosis.
American Journal of Nursing Research. 2017, 5(5), 173-181. DOI: 10.12691/ajnr-5-5-3
Pub. Date: October 17, 2017
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Patient-centric Workplace Culture: A Balancing Act for Nursing Leaders
Original Research
In Australia and globally, developing a patient-centric workplace culture is an ongoing challenge. Nurse managers must reflect on what a balanced functioning of patient-centric workplace culture entails and how to develop it in a context constrained by rising healthcare costs. This study has investigated nurses’ perspective of the association between a patient-centric workplace culture and practical issues such as nurse staffing and perceived quality of nursing care. A mixed methods study design involved sequential (equal status and partially mixed) data gathering from nurses in public hospitals in NSW, Australia. First, a survey questionnaire was employed and yielded 136 responses after adjustment for missing data. This data was analysed using descriptive analysis techniques in SPSS. Then 21 self-nominated nurse managers were interviewed face to face. This qualitative data was transcribed and analysed for recurring themes using a continuous comparative method (CCM). Correlations of patient-centric workplace culture, with nurse staffing (rS = .655) and perceived quality of nursing care (rS = .593) were moderate. Correlation between nurse staffing and perceived quality of nursing care (rS = .410) also existed. Analysis of the interview data resulted in two major themes: the first theme confirmed the association between the three constructs of patient-centric workplace culture, nurse staffing and perceived quality of nursing care. The second theme identified gaps in embedding the espoused patient-centric workplace culture. The study revealed that a patient-centric workplace culture could facilitate positive relationships between nurse staffing and the perceived quality of nursing care. This would happen when patient-centric workplace culture focuses on proactive change management, teamwork and prioritises patient care and adequate nurse staffing. A critical need for nurse managers is to become positive leaders, who can build and embed a patient-centric workplace culture in today’s resource constrained environment.
American Journal of Nursing Research. 2017, 5(5), 165-172. DOI: 10.12691/ajnr-5-5-2
Pub. Date: October 13, 2017
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Effect of Psychodrama on the Severity of Symptoms in Depressed Patients
Original Research
Psychodrama has been successfully used in the management of certain psychosomatic ailments. However, no controlled studies examining its effectiveness in depression have been conducted. The aim of this study was to evaluate the effect of a program for psychodrama on the severity of symptoms of depressed patients. This quasi-experimental study was conducted in El-Abassia Hospital for mental health. It included a sample of 30 patients having depression, randomly divided into a study group to attend a psychodrama intervention, and a control group having routine hospital protocol. Data were collected using an interview form with Beck Depression Inventory (BDI). The study was carried out in assessment, implementation, and evaluation phases. The study group was exposed to 12 one-hour sessions of psychodrama. The study lasted from September to December 2016. The patients in the two groups had similar demographic characteristics. At the pretest, the depression score was higher in the study group (p=0.003), but its duration had no statistically significant difference. After the intervention, all study group patients had no depression, except one, compared to 9 (60.0%) In the control group (p=0.08). The median score of depression was lower in the study group (1.0) compared with the control group (10.0), p=0.001. In multivariate analysis, the intervention was identified as a significant independent negative predictor of the depression score, while married status was a positive predictor. The results point to the effectiveness of a psychodrama intervention in alleviating the severity of depression. Hence, it is recommended to utilize this technique on a larger scale in patients with major depression.
American Journal of Nursing Research. 2017, 5(5), 158-164. DOI: 10.12691/ajnr-5-5-1
Pub. Date: September 20, 2017
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