Volume 7, Issue 6

Impact of Non-Pharmacological Interventions on Improving Sleeping Habits among Children Suffering from Sleep Disorders
Original Research
Background: Non-pharmacological interventions improve sleeping habits and it prevents many adverse health consequences which include altered cognitive function and child mood. Aim: This study aimed to evaluate the impact of non-pharmacological interventions on improving sleeping habits among children suffering from sleep disorders. Design: A quasi-experimental research design was used in this study. Setting: This study was conducted in Out-Patient Clinics of Psychiatric Center and Pediatric Hospital affiliated to Ain-Shams University.Sample: A purposive sample was used to conduct this study. The total number of the study sample was 75 children with a confirmed diagnosis of sleeping disorders. Tools: Three tools were used in this study for data collection, 1) A structured interview questionnaire to assess children's demographic characteristics and children's knowledge regarding non-pharmacological interventions, 2) Children’s sleeping habits questionnaire (CSHQ) and 3) An observational checklist (pre/post-tests) to evaluate practices of non-pharmacological interventions. Results: There was a lack of children’s knowledge about non-pharmacological intervention, the mean±SD of 5.6±1.2, which increased in post - intervention with a statistically significant difference (P=<0.001). Moreover, there was a lack of children’s practice toward non-pharmacological intervention, with mean±SD of 4.78±3.69 which increased in post -intervention. And children reported improved sleep habits (Children’s Sleeping Habits Questionnaire: 16.27 ± 4.987 versus 11.88 ± 4.420 p=0.018. Conclusion: The current study concluded that the non-pharmacological interventions (sleep restriction, stimulus control, cognitive therapy, sleep hygiene, and relaxation training)had an evident effect on improving sleeping habits and their reported practices among Children Suffering from Sleeping Disorders. Recommendations:The study recommended that non-formal classes should be to teach children, parents, and teachers about improving sleeping habits through optimal use of the non-pharmacological intervention.
American Journal of Nursing Research. 2020, 7(6), 1116-1124. DOI: 10.12691/ajnr-7-6-26
Pub. Date: October 29, 2019
562 Views350 Downloads
Developing Strategies for Overcoming Challenges Facing Nursing's Clinical Teaching
Original Research
Vocational students considered young workers who are usually injured at the worksite. Education and awareness are necessitated for them. Background: Clinical teaching is a very important mission of nursing education because the clinical experiences connect theory to practice. Where students who achieve good practice and safety technology in the available health facility and teaching atmosphere would establish nursing competencies through practicing partnerships [1]. Nursing education is the most viable study to continue the education process for practice [2]. Aim: This study aims to develop strategies to overcome the challenges facing nursing's clinical teaching. Method: Current investigation was conducted at Nursing faculty, Zagazig University on 3 studied groups: first; clinical instructors (77), second; faculty students (330) and third, jury (7). Tools: Three tools were utilized for data collection, including challenges assessment questionnaire and two experts' opinionnaires format. Results: The most frequent challenges facing nursing’s clinical teaching are: the clinical instructor was not concerned with the issues that students raised (92.2), the variance between faculty goals for students and clinical site goals (87), students didn't have the required clinical skills in the clinical setting (85.2), and, the clinical instructors enforce students for involvement in practice (82.1). Conclusion: The questionnaire of assessing nursing clinical teaching challenges is reliable, valid and usable. The strategies for overcoming nursing clinical teaching challenges was developed and validated.
American Journal of Nursing Research. 2019, 7(6), 1102-1115. DOI: 10.12691/ajnr-7-6-25
Pub. Date: October 29, 2019
1260 Views533 Downloads
Comparison of Sexual Function between Circumcised and Non- Circumcised Women at Reproductive Age
Original Research
Background: Female circumcision is a major public health problem, especially in developing countries. Aim:This study aimed to compare of sexual function between circumcised and non-circumcised women at reproductive age. Design: A descriptive cross sectional design was utilized to conduct this study. Setting: The present study conducted at Family Planning Unit, Mansoura University Hospital, Egypt. Sample: A convenient sample of two hundred healthy married women at their reproductive age who are sexually active for the previous six months, either circumcised or not, who attended to the previous setting for utilization of family planning services from the beginning of July to the end of December 2018. Tools: Data were collected through I: Interviewing schedule to assess socio-demographic characteristics of the married women. II: Arabic version of Female Sexual Function Index (FSFI) questionnaire to assess women’s sexual function and dysfunction. Results: Total mean score of FSFI for the circumcised women (21.69 ±5.7) was lesser than the total mean score of FSFI for the non- circumcised women (29.12 ±4.54) with a highly statistically significant difference. Conclusion:Based on the study finding, there was a difference between circumcised and non-circumcised women’s sexual function, wheremajority of the circumcised women had sexual dysfunction according to FSFI compared to only one- third of the non- circumcised women who had sexual dysfunction. Recommendation: Raising awareness of parents about the health consequences of female genital mutilation on their daughter future sexual health via periodical community projects.
American Journal of Nursing Research. 2019, 7(6), 1094-1101. DOI: 10.12691/ajnr-7-6-24
Pub. Date: October 29, 2019
1759 Views623 Downloads
Effect of Sham Feeding on Postoperative Clinical Outcomes among Patients Undergoing Elective Abdominal and Gynecological Surgeries
Original Research
Sham feeding has been demonstrated to be one of the methods to increase bowel motility. Gum chewing, as an alternative to sham feeding, provides the benefits of gastrointestinal stimulation without the complications associated with feeding. Aim: to evaluate the effect of sham feeding on postoperative clinical outcomes among patients undergoing elective abdominal and gynecological surgeries. Subjects: A purposive sample including 150 patients who were admitted to the general surgical and gynecological unit for undergoing elective open abdominal surgeries such as cholecystectomy, appendectomy, hysterectomy, myomectomy. Were divided randomly into two equal groups 75 patients in each Study group (I): practice post-operative sham feeding in addition to the usual routine hospital care such as early mobilization and Control group (II):Follow the usual routine hospital care such as early mobilization only. Setting: The study was conducted at the general surgical and gynecological unit of Menoufia University Hospital. Instruments:Three instruments were utilized, I: A structured Interviewing Questionnaire, II:Postoperative Patient's Outcomes Questionnaire and III:Visual Analogue Scale (VAS). Results:Significant statistical differences existed between both groups regarding the time of resumption of gastrointestinal functions, postoperative ileus symptoms, and incidence of nausea, vomiting, pain and length of hospital stay. Conclusion: Patients who practiced chewing gum as alternative for sham feeding experience earlier return of bowel motility in terms of bowel sounds, first flatus and feeling of hunger than those patients who did not practice chewing gum. Furthermore, there was a significant reduction in pain and length of hospital stay among patients who were practice chewing gum than those who were not. Recommendations: the study recommended that: Sham feeding in a form of gum chewing should be added in the protocol of postoperative nursing care and conducting further studies for evaluating the effect of sham feeding on postoperative ileus among patients undergoing abdominal and gynecological surgeries using a larger sample and different geographical areas.
American Journal of Nursing Research. 2019, 7(6), 1086-1093. DOI: 10.12691/ajnr-7-6-23
Pub. Date: October 29, 2019
2874 Views1058 Downloads2 Likes
Sleep Hygiene: Improving Sleep Quality and Fatigue for Patients Receiving Chemotherapy
Original Research
Sleep and fatigue disturbance are the foremost frequent aspect experienced by patients with cancer. It has been a neglected problem as a result of the normal and transient reaction to cancer and its treatment, in addition to the underreporting of these disturbances by patients receiving chemotherapy. Aim: The study aimed to evaluate the effect of sleep hygiene instructions on sleep quality and fatigue for patients receiving chemotherapy. Design: A quasi-experimental research design was utilized. Setting: The study was conducted at inpatient department at oncology center Mansoura University, and follows those patients at outpatient clinics.Subjects: Purposive sample of 100 adult patient receiving chemotherapy were recruited in this study. Tools: Three tools were used. Tool I: Assessment interview questionnaire sheet includes demographic and health relevant data, Tool II: Pittsburgh Sleep Quality Index and Tool III: Arabic version of Fatigue Severity Scale (FSS-Ar). Results: There was a statistically significant difference in sleep and fatigue total scores pre and post intervention. Also there was a statistically significant positive correlation between sleep problems and fatigue. Conclusion: The study concluded that, majority of participants had poor sleep quality and nearly two thirds of them suffer from some degree of fatigue before applying sleep hygiene instructions. While there was a highly statistically significant improvement of PSQI status and FSS grads total score after applying these instructions. Recommendation: This study recommended that, applying sleep hygiene as a routine of nursing care provided for patients receiving chemotherapy and performing additional research to understand the relationship of fatigue and sleep disturbance.
American Journal of Nursing Research. 2019, 7(6), 1078-1085. DOI: 10.12691/ajnr-7-6-22
Pub. Date: October 29, 2019
3006 Views1086 Downloads1 Likes
The Effect of Educational Intervention about Incivility on Psychological Wellbeing and Burnout among Nurses
Original Research
Workplace incivility pervades nursing practice and adversely effects nurses, patients, and organizations. Failure to address uncivil behaviors can negatively affect the physical and mental health of nurses. As a result, nurses may experience decreased job satisfaction, increased turnover, absenteeism and work-related injuries. The study aimed to evaluate the effect of educational intervention about incivility on psychological wellbeing and burnout among nurses. Quasi-experimental design with pre-posttest was used to achieve the aim of this study. The study was conducted in Menoufia Main university hospital. A simple random sample of 50 staff nurses were selected to constitute the present study. Data were collected using workplace incivility scale, the ryff scales of psychological well-being and maslach burnout inventory (MBI). The results was found that, the studied nurses were in age group (23-49) years and the mean age is 34.14years, the majority of the sample 72% had Bachelor of nursing, 96% were female, The highest frequency (94%) was married. There was a highly statistically significant difference found regarding psychological well- being, burnout and incivility among the studied nurses pre and post intervention .In conclusion, one can say that the implementation of educational intervention about incivility has a positive effect on improving psychological well-being and decrease burnout among nurses. Based upon the results of the study, a recommendation to implement educational intervention about incivility throughout the organization to improve psychological well-being and decrease burnout.
American Journal of Nursing Research. 2019, 7(6), 1069-1077. DOI: 10.12691/ajnr-7-6-21
Pub. Date: October 29, 2019
3340 Views1180 Downloads2 Likes
The Relationship between Compliance and Quality of Life among Adolescents with Diabetes Mellitus Type 1
Original Research
Background: Puberty is a period of rapid growth and hormonal changes and is often characterized by deterioration in glycemic control, and all of these factors may promote the development of diabetes complications. Type 1 diabetes mellitus (T1DM) is a chronic disease requiring complex management, including blood glucose monitoring, insulin administration along with diet restrictions, which can have a negative impact on the quality of life (QoL) of adolescents. The aim of the study: This study aimed to investigate the relationship between compliance and quality of life among adolescents with diabetes mellitus type 1. Design: A descriptive cross-sectional design was utilized in this study. Setting: This study was conducted at the outpatient clinics in Zagazig University Hospitals at the pediatrics unit and the health insurance clinic for diabetes in Zagazig city. Subjects: A convenient sample of 80 adolescents diagnosed with type 1 diabetes Three tools were used for data collection, namely; A structured interviewing questionnaire, Diabetes self-management profile, and Diabetes quality of life for youths scale. The results: Slightly more than half of adolescent had a moderate knowledge of diabetes mellitus (53.8%), the highest percentage of the study sample had inadequate levels of compliance to diabetes treatment recommendations and perceived their quality of life as low (61.3% & 67.5%, respectively). Conclusion: It was found that there was a statistically significant relation between adolescents' compliance and quality of life score. Recommendations: Conduct educational program for adolescents and their parents to increase the level of their knowledge and compliance for diabetes management to improve QOL for all diabetic adolescents.
American Journal of Nursing Research. 2019, 7(6), 1057-1068. DOI: 10.12691/ajnr-7-6-20
Pub. Date: October 29, 2019
3135 Views819 Downloads
Education Program for Mothers of Children with Autism Spectrum Disorder: Mothers and Child Outcomes
Original Research
Background: Mothers play an important role in supporting their children with autism. They not only drive the decision making process, but they take a primary role in delivering the intervention. Consequently, they require advice, emotional support, and training in working with their children through providing education for mothers to update and accurate information about available treatment options and support services for autism. This study aimed to assess the effects of an education program for mothers of children with autism spectrum disorder on mothers and child outcomes. Design: A quasi experimental design was used in this work. Setting: This study was conducted at two settings, namely; Speech and Hearing clinic at Al Ahrar Hospital and Speech clinic at Zagazig University Hospitals. Subjects: Included all accessible autistic children aged 3 – 12 years (n=50) and all accessible mothers of autistic children (n=50). Three tools were used for data collection, namely; A questionnaire, interview sheet, Mother's knowledge regarding the care provided to their autistic children, and Child observation sheet. The results: The highest percentage of mothers had an unsatisfactory and low levels of knowledge and awareness regarding the care provided to autistic children before implementation of the program (80% &76%, respectively). Meanwhile, after implementation of the program, the majority of mothers had a satisfactory and moderate levels of knowledge and awareness with a statistical significance differences (70% & 70%, respectively). Before implementation of the program the half of mothers reported that their autistic child's behavior had a moderate defect level (50 %). While after the implementation of the program this percentage increases to 60% but still moderate. Conclusion: It was found that there were a positive correlation between mothers' knowledge and both of awareness and change in autistic child's behavior scores after implementation of the program. Also, there was a positive correlation between change in autistic children behavior and mothers' awareness scores after implementation of the program. Recommendations: Conduct awareness raising program to improve knowledge and attitude of the community towards the autistic children and their families through mass media.
American Journal of Nursing Research. 2019, 7(6), 1046-1056. DOI: 10.12691/ajnr-7-6-19
Pub. Date: October 28, 2019
2681 Views800 Downloads
Maternal Competence in the Context of Infant Feeding: A Concept Analysis
Original Research
Background: Maternal competence in infant feeding is important to foster infant growth and development; however, maternal competence has been defined inconsistently using a variety of terms in relation to different contexts. Aim: This work provides an analysis of the concept of maternal competence in the context of infant feeding. Methods: The concept was analyzed using Walker and Avant's eight-step concept analysis method. Results: Maternal competence in infant feeding is defined as the possession of the knowledge, skills, abilities, responsiveness, and sensitivity that are required to provide optimal infant feeding. The concept's antecedents are the mother-infant relationship, maternal expectations, and support systems. The consequences are optimal nutrients intake, maternal confidence, infant's self-regulation and infant’s healthy growth and development. Conclusions: This concept analysis identified all related attributes and provided a clear definition of maternal competence in infant feeding. Information from this analysis can be used to develop a conceptual framework for maternal competence in infant feeding.
American Journal of Nursing Research. 2019, 7(6), 1041-1045. DOI: 10.12691/ajnr-7-6-18
Pub. Date: October 28, 2019
1896 Views463 Downloads
Efficacy of Dressing by Aloe Vera Gel on Healing and Pain among Burned Patients
Original Research
Aloe Vera gel plays an important role in managing burn by rapid healing process, it increases growth factors, by collagen and proteoglycan synthesis, also it contains many important components as nutrients, vitamins, antioxidants, antimicrobial, anti-inflammatory and Magnesium lactate has anti-itching and analgesic effect by inhibiting histamine-decarboxylase which controls pain level and promoting wound healing furthermore reduction of duration of patient hospitalization. The aim of the study; this study aimed to evaluate the efficacy of dressing by Aloe Vera gel versus conventional dressing on the healing process and pain among burned patients. Subjects & Method; design: Quasi-experimental research design was utilized to achieve the aim of the study. Research setting: The current study was conducted at burn unit and burn out patient's clinic of Shebin El-Kom Teaching Hospital, Menoufia Governorate- Egypt. Subjects; a purposive sample of 50 patients; they were divided into two equal groups 25 patients in each as follows: 1-The study group (I): dressing by Aloe Vera gel 2- The control group (II): dressing by conventional dressing or routine hospital. Tools: two tools were utilized to collect the necessary data. Tool one: interview questionnaire sheet; divided into four parts: Part one: Sociodemographic and medical data; Part two: Bio-physiological measurements (Vital signs; Patient’s Knowledge about nutrition and Laboratory investigations); Part three: Burn characters (parameters); as total body surface area (TBSA); degree of burn; presence of wound oozing; eschar (dry, black necrotic tissue); burn odor; wound redness and swelling, healing process and burn complication. Part four: Photographs. They were taken by researchers to evaluate the healing process at the beginning of the treatment, then every week until complete healing occurred. Tool two:Visual analogue pain scale. The results:most patients in study group hadn't characters of wound infection after one week of Aloe Vera gel dressing application (fourth assessment); moreover during fifth and sixth assessment all patients in the study group were free from symptoms of wound infection, while 48% in the control group had characters of wound infection by last two assessments. The rapid healing process occurred, decreased level of pain and length of hospitalization stay among the study group after dressing application by Aloe Vera gel than the control group. Conclusion: Depending on the present study results, it can be concluded that Aloe Vera gel promoted wound healing of first and second degree of burns better than traditional dressing in management methods, it also reduces pain level so lesser length of patient hospitalization stay. Recommendation: Based on the previous researches and the current study results, the researchers recommended that; use Aloe Vera gel in a dressing of the burned patient especially second unhealed or delayed. Apply research on a large number of patients with more times for follow up.
American Journal of Nursing Research. 2019, 7(6), 1028-1040. DOI: 10.12691/ajnr-7-6-17
Pub. Date: October 21, 2019
2455 Views549 Downloads
Compliance with Recommended Universal Precautions for Control Infection by Needlestick Injury among Nursing Students
Original Research
Health care workers (HCWs) such as nurses are usually exposed to infectious diseases. Some infectious diseases do not have any offered vaccination or complete treatment, thus blood-borne infections are a serious cause of anxiety for HCWs. Objective of this study was to assess nursing students’ knowledge, observation of environmental risk factors, and compliance with recommended universal precautions about the prevention of infectious diseases by needlestick injury. Methods: descriptive research design was used. Setting of this study was conducted in the college of nursing at Jazan University. Sample: convenient sample of 120 students was used in the present study. Tools of data collection were consisting of four tools first; socio-demographic characteristics sheet, second; students’ knowledge assessment sheet, third; students’ compliance actions assessment sheet; fourth observations of environmental and risk factors. Results of the study revealed that, most dominant place for taking first teaching about prevention of blood borne organisms is classroom (46.4%) for 8th level students, while labs is taking the highest response (42.2%) with in 3rd level students. The majority of the 3rd level students (87.5%) had fair knowledge scores related to the subject compared to (89.3%) of the 8th level students. More than two thirds (68.7%) of the first year students had fair compliance scores with mean scores (29.10±4.17) compared to (48.2%) of the fourth year with mean scores (29.30±5.31). Conclusion: Majority of the studied students had average knowledge about prevention of infectious disease related needlestick injuries. Minority of the students in both first and fourth year had good compliance with recommended universal precautions. More than half of the students in third level and near half in eighth level had poor environmental risk factors. Recommendations: Establishing educational and awareness’ programs for all nursing students about the dangerous and prevention of occupational exposure to blood borne pathogens, infectious diseases and needlestick injury.
American Journal of Nursing Research. 2019, 7(6), 1020-1027. DOI: 10.12691/ajnr-7-6-16
Pub. Date: October 21, 2019
2770 Views701 Downloads
Effect of Self Instructional Module on awareness of Polycystic Ovarian Syndrome among Adolescent Students
Original Research
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects 6% to 10% of women of reproductive age.. Aim of the research was to examine the effect of self instructional module on awareness of polycystic ovarian syndrome among adolescent students. Design: A quasi-experimental research design was adopted to fulfil the aim of this study. Setting: The study was conducted at nursing institute of Benha teaching hospital and nursing institute of health insurance hospital. Sample:A purposive sample of one hundred and seventy five adolescent girls among those attending the above mentioned setting. Tools: Data were collected through four main tools: A Structured interviewing questionnaire, knowledge questionnaire regarding polycystic ovarian syndrome, adaptive healthy measures questionnaire regarding PCOS and adolescent student’s satisfaction sheet. Results: showed that the majority of adolescent students (89.7) had no information about PCOS while minority of them had source of information from health team , mass media ,family and friends respectively. and only 6.3 %of adolescent girls had adequate knowledge pre implementation increased to 90.3 % post implementation. Also there was a highly statistically significant difference between total knowledge and total adaptive healthy measures score related to PCOS at the pre and post implementation phases (p<0.001). Additionally the majority of adolescent students were satisfied with the self instructional module implementation. Conclusion: the study concluded that research hypotheses are supported and adolescent students exhibited better awareness regarding polycystic ovarian syndrome after implementation of self instructional module and this support the first hypothesis. Also the majority of adolescent students were satisfied with self instructional module regarding polycystic ovarian syndrome and this support the second hypothesis. Recommendations: Nursing curriculum should be updated to include comprehensive information about PCOS to improve the awareness of adolescents.
American Journal of Nursing Research. 2019, 7(6), 1009-1019. DOI: 10.12691/ajnr-7-6-15
Pub. Date: October 20, 2019
2872 Views710 Downloads1 Likes
Impact of Educational Intervention Program on Diabetic Retinopathy Patient's Compliance
Original Research
Background; diabetic retinopathy can lead to serious vision problems, patient education plays an important role in the management of retinopathy and the Compliance to treatment is a primary determinant of treatment success. Aim of the Study; The study aimed to evaluate the Impact of educational intervention program on diabetic retinopathy patient's compliance. Study Hypothesis; Patients knowledge about diabetic retinopathy will be improve post program than before and Patients compliance will improved after receiving the program. Design;Quasi experimental design used to achieve the aim of the study. Setting; the study was conducted at ophthalmology clinic at Benha University Hospital. Subjects; Convenience sample of 60 patients from both genders selected under criteria. Tools: two tools were used; Structured questionnaire regarding knowledge of diabetic and diabetic retinopathy;which used to assess patient's knowledge about diabetic and diabetic retinopathyand patient's compliance of diabetic retinopathy; to assess patient' compliance It included questionnaire about nutrition and eating habits , physical activity and treatment. Results;mean score of age was age 42.067 ±9.716 also 56.7% are male, (78.3%) are married. Regarding to medical history 70.0% use insulin. and so 78.3% of them post hyperglycemia exposure caused by Sweet diet. Regarding total knowledge pre-program was 93.3 % of patients had unsatisfactory while 80.0% had satisfactory of knowledge post program. Regarding total compliance 95.0 % of patients not adherent preprogram while 96.7% had adherent post program. Also there were positive and highly significant correlations in post program between total knowledge and total compliance. Conclusion: there were highly significant statistically improvement in all items of knowledge and compliance post than preprogram regarding diabetic retinopathy. Recommendations; The need for increasing awareness and also the provision of access to retinopathy screening services to patient, Urgent need to evolve strategies to educate diabetic patients about potential retinopathy complication of diabetes.
American Journal of Nursing Research. 2019, 7(6), 1000-1008. DOI: 10.12691/ajnr-7-6-14
Pub. Date: October 20, 2019
2664 Views697 Downloads
Stress and Anxiety among Junior Nursing Students during the Initial Clinical Training: A Descriptive Study at College of Health Sciences, University of Bahrain
Original Research
Background:Anxiety and stress among nursing students are challenge for academic education and a need exists to explore the factors that contribute to such phenomena among Arab culture. Objective: To assess the anxiety and stress levels among junior nursing students at College of Health Sciences (CHS), University of Bahrain (UoB) during their initial clinical exposure. Material and Methods: A self-administered questionnaire was employed to gather data on perceived stress (5 points likert scale), perceived anxiety (4 points likert scale) and socio-demographic characteristics from 93 second year nursing students at CHS (a response rate of 77.5%). The total scores for each item were summed and average scores were calculated accordingly. Both univariate and multivariate analyses were undertaken in order to identify significant factors that influence anxiety and /or stress levels among students. The p-value of less than 0.05 was considered statistically significant. Results: About four-fifth of the respondents were female students. Most students had normal levels of anxiety while two-third reported moderate stress level. Female gender was the only significant factor that is related to stress in univariate as well as multivariate analyses. Conclusion:Nursing students at CHS had moderate stress level which would have a negative effect on the quality of their education and clinical practice. Further studies are needed to explore effective strategies to deal with anxiety and stress among junior and senior students.
American Journal of Nursing Research. 2019, 7(6), 995-999. DOI: 10.12691/ajnr-7-6-13
Pub. Date: October 16, 2019
2539 Views776 Downloads
Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC)
Original Research
Background: In recent years, different educational approaches have been broadly applied to nursing courses. However, a comparison between these approaches and assessing the students’ satisfaction has not been conducted. Aim: This study was designed to compare FC and ALC with the TLC model in teaching Medical-surgical courses to undergraduate nursing students and to assess the student response when they are asked to compare their experiences in FC, ALC, and TLC. Results: The mean age of the study participants was 22.19 ± 2.40. In terms of marital status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.059). A larger number of married students preferred TLC over ALC/FC and the difference between married and unmarried was significant (p=0.036). Regarding residential status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.034). A larger number of rural residents preferred FC over ALC/TLC and the difference between rural and urban residents was significant (p=0.036). In terms of previous GPA scores, the difference between the students preferring FC over ALC/TLC was significant (p=0.008), where a larger number of students preferred FC over other teaching methods. Conclusion: The student satisfaction in FLC, TLC, and ALC varies based on their social/residential statuses as well as their study habits and out of class self-study hours.
American Journal of Nursing Research. 2019, 7(6), 991-994. DOI: 10.12691/ajnr-7-6-12
Pub. Date: October 15, 2019
2406 Views895 Downloads
Training Program for Rural Community Health Workers about Breast Self-Examination at Assiut Governorate, Egypt
Original Research
Breast Self-Examination (BSE) has a greatest role in the early discovery of breast cancer and it is still an important screening tool for early detection of Breast Cancer (BC) in developing countries. The study aimed to:Assess the impact of training program on improving knowledge and practices of rural community health workers regarding BC and BSE.Subjects and Methods: Design: Quasi-experimental research design.Sample: A total of 74 rural community health workers recruited in this study. Toolsof the study: Two tools used; Tool (I): Self-administrated questionnaire; which divided into two parts, Part (1):Included participants’ personal data, Part (2): Included questions to assess knowledge about BC and BSE. Tool (II): BSE performance checklist. Results: The participants were aged less than 20 years with university education (54.1% and 51.4% respectively); 73% of them were from rural area and 13.5% had family history of BC. There were highly statistical significant differences between total score of knowledge and practice during the three phases of the study pre, post and follow-up test p-values 0.000. Conclusion: A remarkableimprovement was noticed in the participants' level of knowledge and practices during the posttest and after three months of follow-up. Recommendation:Establishment of ongoing training intervention to increase rural community health workers’ confidence and skills for teaching preventive health behaviors including BSE to larger society.
American Journal of Nursing Research. 2019, 7(6), 983-990. DOI: 10.12691/ajnr-7-6-11
Pub. Date: September 14, 2019
3108 Views967 Downloads
Effect of Educational Intervention on Critical Care Nurses' Adherence to the Clinical Practice Guidelines for Preventing Venous Thromboembolism in Critically Ill Patients
Original Research
Background: Critically ill patients are at high risk for developing DVT. The prevalence of DVT and PE is underestimated in the ICU, as it is often clinically silent, especially in sedated and mechanically ventilated patients. ICU acquired thromboembolic events are difficult to diagnose, as they may mimic many other diseases. Identifying patient populations at risk for DVT and implementing evidence-based guidelines can decrease the number of unpleasant effects of this disease. Although the supporting evidence about the beneficial effect of the clinical guidelines has been in place for a long time, the guidelines have been greatly underused. Aim: To examine the effect of educational intervention on critical care nurses' adherence to the clinical practice guidelines for preventing venous thromboembolism in critically ill patients. Methods: Design: A quasi-experimental design (pre/post test) was used. Setting: The study was conducted at different ICUs at Menoufia University Hospital, Shebin El-Kom district, Menoufia Governorate. Sample: A convenience sample of 192 critical care nurses working at different ICUs who provide direct nursing care to critically ill patients at Shebin El-Kom, Menoufia University Hospital were recruited for this study. Nurses participated in the study were approached over an eight week period. One hundred and sixty-seven nurses participated in the study. Novel nurses who have less than 6 months experience in ICU were excluded because they did not have enough experience about clinical practice guidelines for DVT prevention. Three tools were used for data collection: a) Demographic sheet; b) Availability of DVT Prevention Clinical Practice Guidelines and c) The Clinical Nurses Practice Guidelines of DVT Prevention Observational Checklist (CNPG). Results: Clinical practice guidelines for DVT prevention is not available in the ICUs and the participated nurses have not been oriented or received any information about the practice guidelines. As a consequence, they are not implementing the guidelines in their daily practice. Also, there was a statistically significant improvement in the critical care nurses’ adherence to the clinical practice guidelines for preventing DVT post-intervention compared with pre-intervention. Recommendations: Accurate individualized assessment of VTE risk is critical to optimize prophylaxis. VTE risk assessment and prophylaxis recommendations should be integrated into hospital protocols, to be easier for nurses to comply with guidelines than if they are not standard practice.
American Journal of Nursing Research. 2019, 7(6), 974-982. DOI: 10.12691/ajnr-7-6-10
Pub. Date: October 07, 2019
4018 Views1524 Downloads
The Effect of Non-Sugared Gum Chewing With Early Ambulation versus Early Ambulation Only on Recovery of Bowel Function after Elective Cesarean Section
Original Research
Background: The rate of CS is surged high in Egypt at 2014. Ileus is the most common CS complication. It may become serious enough to alter women post CS accommodation; delay wound healing and increase hospital stay. Aim: to investigate the effect of non-sugared gum chewing with early ambulation versus early ambulation only on recovery of bowel function after elective cesarean section. Research design: Randomized controlled clinical trial. Setting:Damanhour educational institution affiliated to ministry of health at Elbehira governorate Egypt. Participants: A systematic random sample of 100 woman undergoing elective cesarean section. Tools: Three tools were used for data collection: Structured Interviewing Schedule, Pre and intra-operative assessment sheet, bowel functions assessment sheet. Results: The study results shows statistically significant improvement in all bowel functions among intervention group compared to control. Where, The mean time hours to the first bowel sound (3.90±0.893 compared to 5.34±0.939), onset of gas passage (6.78±0.996 compared to 7.06±1.105), feeling of hunger time (7.98±1.134 compared to 9.40±1.212), begins oral fluids (3.98±0.775 compared to 5.78±0.996), feeding time (10.16±0.817 compared to 11.92±1.712), onset of defecation (12.180±1.240 compared to 14.48±1.403) were significantly shorter in the non-sugared gum chewing with early ambulation group than early ambulation only. Furthermore, abdominal distention and nausea are significantly higher among control group than intervention. Conclusion: Non-sugared gum chewing with early ambulation significantly enhance regain of all bowel functions post CS than early ambulation only. In addition, abdominal distention and nausea were significantly higher in non-sugared gum chewing with early ambulation group than early ambulation only. Recommendations:Non-sugared gum chewing could be added to post cesarean care protocols.
American Journal of Nursing Research. 2019, 7(6), 965-973. DOI: 10.12691/ajnr-7-6-9
Pub. Date: September 28, 2019
3041 Views896 Downloads1 Likes
Self-assessment of Undergraduate Nursing Students about Their Knowledge, Behavior, and Attitude in Relation to Evidence Based Practice
Original Research
Background: Evidence-based practice (EBP) is used worldwide to improve the quality of patient care to provide cost-effective care. EBP is a mandate for nursing practice combining individual clinical judgment with available expertise to generate a positive outcome for the patient. Objective: The study aimed to describe the self- assessment of undergraduate nursing students about Knowledge, behavior, and attitude in relation to Evidence Based Practice. A Cross- sectional study design. Convenience sampling technique was used to include all consenting nursing students from fifth level to eighth level (3rd and 4th year) (n=255) student. The research was carried out at the Faculty of Nursing, Princess Nourah Bint Abdulrahman University. A self- administered questionnaire. The EBP was done by adopting EBP questionnaire that has been created by Upton et.al (2006) & Ruzafa-Martinez et.al (2017): The results indicated that our respondents generally viewed EBP positively and their attitudes towards EBP tended to be more positive than their knowledge and behaviors about EBP. Exactly 76.6% of respondents in our study had a positive attitude toward EBP. Finally, our study showed statistically significant correlations between practice, knowledge and attitudes related to evidence-based practice. Many studies have established that the three segments of knowledge, attitude, and behavior are inseparably interlinked and strength each other in EBP. Conclusion of our research showed that factor of training in EBP has an effect on nursing students' knowledge, attitudes and behaviors about EBP. To the possible extent, training will help to increase positive beliefs and attitudes regarding EBP. Further investigation regarding the effect of gender difference in EBP is needed.
American Journal of Nursing Research. 2019, 7(6), 958-964. DOI: 10.12691/ajnr-7-6-8
Pub. Date: September 28, 2019
3009 Views965 Downloads
Work-Related Musculoskeletal Disorders among Nursing Students during Clinical Training
Original Research
Background: The Musculoskeletal Disorders (MSDs) have a considerable socio economic impact. First, they drive up costs for workers, companies, and society in general. This applies to both direct and indirect costs associated with occupational diseases and industrial accidents. Nursing students experienced the MSD with increased cases amongst nursing staff. Nursing students continue to face the problems of MSD due to the misuse of the good technique to protect them self during clinical training hours. The study aimed to assess work-related musculoskeletal disorders among nursing students during clinical training. A cross- sectional study design used to achieve this aim. Convenience sampling technique was used to include all consenting nursing students from fifth level to eighth level (3rd and 4th year) (n=253) student who were having clinical training. The study took place at the Faculty of Nursing, Princess Nourah Bint Abdulrahman University. The first part include demographic data questions. The second part is a self-reported pain using standardized Nordic questionnaire for the analysis of musculoskeletal symptoms that will assess different body parts namely upper limb, lower limb, and trunk sections of the body. The study illustrated that more than half of students reported pain (71.1%) and ankle or feet (43.9%) during the last 12 months. Consistent also with students who reported MSD in the last seven days, 48.2% of them reported lower back problem. There is significant relationship between number of clinical days (p = 0.05) and MSD, and no significant relationship between the MSDs and the number of the clinical hours per day (p =0.973), weight (p = 0.806). The main conclusion drawn from the current study is that the majority of nursing students are high risk for MSDs due to improper body mechanics or wrong posture.
American Journal of Nursing Research. 2019, 7(6), 952-957. DOI: 10.12691/ajnr-7-6-7
Pub. Date: September 25, 2019
2351 Views666 Downloads
Effect of Nutritional Counseling on Nutritional Practices and Dietary Health Habits of Pregnant Women
Original Research
Background: Diet is an important and modifiable lifestyle behavior that can affect risk factor development for optimal health and well-being. Aim: The aim of this study was to examine the effect of nutritional counseling on nutritional practices and dietary health habits of pregnant women. Research design: Quasi-experimental study design (pre/posttest). Setting: The study was conducted at Al-Ibrahemia health units in Sharkia, Governorate, Egypt. Sample: 75 pregnant women from their fourth month of pregnancy till their seventh month were included in this study. Tool: Structured interviewing questionnaire which included two parts; Part one: personal variables of the studied sample, Part two: Assessment of nutritional practices and dietary health habits. Results: a highly statistically significant difference in nutritional practices and dietary health habits was found in the studied sample post application of the nutritional counseling.
American Journal of Nursing Research. 2019, 7(6), 947-951. DOI: 10.12691/ajnr-7-6-6
Pub. Date: September 24, 2019
2430 Views513 Downloads
Effect of a Care Bundle for Hypertension Control on the Health Outcomes of Hypertensive Patients with Stroke Risk
Original Research
Background: Care bundles contain three to five evidence-informed practices, which need to be delivered collectively and consistently to improve health outcomes of patients. Objectives: this study aimed to assess the level of stroke risk among hypertensive patients, evaluate the effect of a care bundle regarding hypertension control on health outcomes of hypertensive patients with stroke risk and identify factors associated with the effect of care bundles on hypertensive patients. Design: a quasi-experimental research design was used in this study. Setting: this study was conducted in medical outpatient clinics of governmental and health insurance hospitals in Port-Said city. Sample: a purposive sample of 105 patients was included. Instruments: three tools were used for data collection, including a structured interview to assess the socio-demographic characteristics and medical histories of patients, a stroke risk assessment screening tool to determine stroke risk among hypertensive patients and clinical measures such as pulse, blood pressure, body mass index, serum cholesterol and fasting blood sugar. Results: the study results revealed obvious improvements in health outcomes of patients, which were reflected in the significant differences in clinical measures, such as systolic blood pressure, cholesterol level, body mass index and fasting blood sugar, with P-values of 0.000, 0.000, 0.000 and 0.002, respectively, between hypertensive patients pre- and three months post-patient education with the care bundle for hypertension control. However, nearly two-thirds of hypertensive patients in the study sample were at moderate risk for stroke, and the rest were at severe risk. Conclusion: the current study concluded that educating hypertensive patients at risk for stroke with the care bundle for hypertension control could significantly improve their clinical measures. However, further research on a larger sample that includes hypertensive patients with or without stroke risk is recommended.
American Journal of Nursing Research. 2019, 7(6), 942-946. DOI: 10.12691/ajnr-7-6-5
Pub. Date: September 20, 2019
2634 Views780 Downloads
Effect of Three Different Nursing Interventions on Intestinal Motility and Women's Satisfaction Post-Cesarean Section Birth
Original Research
Background: Α major complication of abdominal surgical procedures is paralytic ileus which results in patient discomfort, prolonged length of hospital stay and increased cost of treatment. Aim: The study aimed to evaluate effect of three different nursing interventions on intestinal motility and satisfaction of women's post-cesarean section birth. Design: Randomized controlled comparative study. Setting: This study was conducted in obstetric department, university hospital at Ɓeni-Suef city; it was carried during the period from July 2018 to July 2019. Subjects: Α total of 240 females divided into 4 groups of 60 subjects each were included within the scope of the sample. Method: The women who underwent cesarean birth were divided into four groups, depending on the use of four different methods of gum-chewing, early oral-hydration, and early mobilization. No intervention was applied to the women in the control group. For the four groups, the intestinal sounds were checked every 30 minutes with a stethoѕcope over the abdomen and the first time of passing gas were recorded by asking the mother. The data were evaluated with numbers, mean, and percentage calculationѕ. Results: The three different nursing interventions (sugarless gum chewing, early mobilization and early hydration) are effective methods in respect of intestinal motility and women's satisfaction in post-cesarean section birth. However, earlier, heаring of intestinal sound, pаssing gas and bowel movement in the first group thаt received gum-chewing compаred to the other groups (р < 0.001). Concluѕions: Chewing gum is the best nursing intervention followed by orаl hydration аnd then early mobilization post cesаrean section on intestinal motility, in prevention of pаralytic ileus as well as women's sаtisfaction. Recommendation: Gum chewing, eаrly mobilization and early orаl hydration cаn be conducted sаfely after CЅ delivery. More population should be investigаted for more global evaluation.
American Journal of Nursing Research. 2019, 7(6), 932-941. DOI: 10.12691/ajnr-7-6-4
Pub. Date: September 20, 2019
3226 Views1084 Downloads
The Effectiveness of Psycho-educational Program on Emotional Regulation and Problem-Solving among Preparatory School Students
Original Research
“Improving emotional regulation and problem-solving in youth are very important to decrease the risk of substance abuse, violence, and decreased health costs”. The aim of the study was to evaluate the effectiveness of the psycho-educational program on emotional regulation and problem-solving among preparatory school students. A quasi-experimental research one group pre-test and post-test design was used to achieve the aim of the study. This study was carried out at two preparatory schools, one at Quasna and one at Ebnhas, Menoufia Governorate, Egypt. A purposive sample of 130 students was selected from the above-mentioned settings. Three tools were used to collect the data of the study 1) A constructed interview questionnaire to assess socio-demographic characteristics of the students and their parents 2) Emotional regulation strategies questionnaire 3) Problem-solving scale. The main findings of this study revealed that there was a statistically significant increase in the mean values of all subscales and total score of emotional regulation strategies and problem-solving post-program than pre-program in the studied participants at p-value (0.001). There was a significant positive correlation between the percent increase in emotional regulation strategies and percent increase in problem-solving in the studied participants (r=0.48; p<0.001). It was concluded that the psycho-educational program had a great effect in improving emotional regulation strategies and problem-solving skills among the students. Recommendation: Generalize the application of the psycho-educational program to all preparatory schools to improve their emotional regulation and problem-solving skills.
American Journal of Nursing Research. 2019, 7(6), 922-931. DOI: 10.12691/ajnr-7-6-3
Pub. Date: September 15, 2019
4184 Views1546 Downloads
Effect of Skin Care and Bony Prominence Protectors on Pressure Ulcers among Hospitalized Bedridden Patients
Original Research
Background: Pressure ulcers represent a common health problem among the immobilized patients that prolong their period of hospitalization. The skin care, reduction of pressure on the bone prominence areas, and mobilizing the bedridden patients can provide a significant difference in pressure ulcer development. Aim of the study was to evaluate the effect of skin care and bony prominence protectors on pressure ulcers among the hospitalized bedridden patients. A quasi-experimental researchdesign was adopted. Setting: The study was carried out at the orthopedic and ICUs of Menoufia university hospital, Menoufia governorate, Egypt. Subjects: A total of 282 patients were recruited. Tools: Five tools were used included the structured questionnaire, Braden Scale for Predicting Pressure Sore Risk, Pressure Ulcer Scale for Healing, Katz Index of Independence in activities of daily living, and Glasgow Coma Scale. Results: The mean age for the patients was 48.7 ± 13.3 years old. Three quarters of the sample were adult and 25.5% was elderly patients with mean age 64.97 ± 5.21 years old. 96.2% of the adult patients and all the elderly patients had a high risk for bedsores. The reported causes for pressure ulcers were the increased level of dependence due to immobility, uncontrolled chronic diseases, urinary and fecal incontinence, anti-inflammatory and corticosteroid medications, obesity, edema, anemia and dementia. There was a reduction of pressure ulcer risk with a statistically significant difference between the pre and post-test for the Braden score and pressure ulcer healing score (P < 0.001**). Conclusion: Skin care and bony prominence protectors can reduce the risk for pressure ulcers.Recommendations: The nurses should encourage the patient's mobility, assess the skin regularly, and provide skin care especially in the scapula, elbows and buttocks for the ICU patients and focused the skin care in the knee, heel, buttocks and toes for the orthopedic patients.
American Journal of Nursing Research. 2019, 7(6), 912-921. DOI: 10.12691/ajnr-7-6-2
Pub. Date: September 05, 2019
3431 Views1210 Downloads
Insomnia among Patients with Schizophrenia: The Effect of Sleep Hygiene Guidelines
Original Research
Schizophrenia is a major psychiatric disorder that has a massive, long-lasting negative impact on the patients as well as society, the vast majority of patients with schizophrenia report insomnia, which tend to precede illness onset and can predict an acute exacerbation of psychotic symptoms. The aim of this study is to evaluate the effect of sleep hygiene guidelines on insomnia among patients with schizophrenia. A quasi-experimental design (pretest - posttest) was used to achieve this aim. The study was conducted at The Psychiatric and Addiction Treatment Hospital in Meet-Khalaf at Menoufia Governorate, Egypt. A Purposive sample of 65 patients with schizophrenia from inpatient unit of the above mentioned setting was recruited for this study and randomly divided into two equal groups study and control group. Three tools for data collection were used: Tool (I): Structure interview schedule to assess socio demographic data, Tool (II): Insomnia Severity Index (ISI) to assess the subject's level of insomnia, Tool (III): Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The study illustrated that there was a statistically significant improvement in quality of sleep among patients with schizophrenia in study group compared to control group. Conclusions: the sleep hygiene guidelines were effective in improvement of sleep quality among patients with schizophrenia in study group.Recommendation: Sleep hygiene guidelinesshould be routinely applied to all patients with psychiatric illness to improve their quality of sleep and relive insomnia.
American Journal of Nursing Research. 2019, 7(6), 903-911. DOI: 10.12691/ajnr-7-6-1
Pub. Date: September 01, 2019
3907 Views1376 Downloads