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   Table of Contents - Current issue
Coverpage
January-June 2019
Volume 20 | Issue 1
Page Nos. 1-77

Online since Wednesday, October 9, 2019

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EDITORIAL  

A caring framework for teaching to care p. 1
Vinitha Ravindran
DOI:10.4103/IJCN.IJCN_14_19  
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CONCEPTS AND ISSUES Top

Teaching angels to fly p. 3
Prashanth Padmini Venugopal
DOI:10.4103/IJCN.IJCN_8_19  
This article is concerned with the influence teachers of nursing have on the students. In particular, it talks about the concept of conventional discipline and the perception of nursing students regarding the type of disciplining. The article also focuses on identifying what causes misbehaviour in students and how to tackle various levels of indiscipline among nursing students. The aim of this article is to bring together and summarise the current student–teacher paradigm and how it needs to be changed using a selection of techniques that have been highly successful globally in improving student performance and resulting in a better outcome.
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Translational research p. 7
Jemimah Jayakumar, Rogina JS Savarimuthu
DOI:10.4103/IJCN.IJCN_9_19  
Translational research (TR) aids in transforming research findings into practical actions. TR starts from observations and experiences of patterns and relationships in a researchers' world, which creates research questions. The research question is answered in stages of research starting from the laboratory to testing in clinical trials and then moving onto checking efficacy in patients and communities. Nurses utilising TR can improve quality of nursing care. The phases and stages of TR are discussed in this paper.
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CLINICAL ARTICLES Top

Care of patients with eosinophilic granulomatosis with polyangiitis p. 11
Blessing Reena Dason
DOI:10.4103/IJCN.IJCN_10_19  
Eosinophilic granulomatosis with polyangiitis formerly known as Churg–Strauss syndrome (CSS) is a multisystemic rare autoimmune disorder which results in restriction of blood flow to the vital organs, particularly the respiratory tract. CSS occurs in patients with a history of asthma or allergy. It has complex pathophysiology involving genetic factors, extrinsic agents and different cell types such as T-cells, oesinophils, B-cells, resident cells and anti-neutrophil cytoplasmic antibodies. Treatment mainly involves the administration of corticosteroids. Better knowledge about the disease condition and its treatment will assist nurses to educate the patients regarding the illness and prevention of further complication by adapting a healthy lifestyle such as regular exercise, Vitamin D supplement, diet control, smoking cessation and regular follow-up.
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Edwards' syndrome: A case study p. 18
Cecilia Katasi
DOI:10.4103/IJCN.IJCN_11_19  
Edwards' syndrome, also known as trisomy 18, is a rare genetic disorder caused by the presence of extra 18th chromosome. Most babies with this condition die before or shortly after being born. Some children with this disorder rarely may survive beyond 1 year or into adulthood. Their growth and development is severely hampered. They have severe mental and life-threatening physical disabilities. A child with trisomy 18 is usually born with low birth weight, associated with heart defects and other abnormalities such as micrognathia, clenched fist with overlapping fingers, short sternum and club foot. There is no definitive treatment for babies with Edwards' syndrome. It is very challenging and difficult for parents to take care of a child with trisomy 18, so it is important for parents to get support from healthcare providers to provide the best quality of life for the child.
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RESEARCH ARTICLES Top

Risk factors and knowledge of osteoporosis in rural pre-menopausal women p. 22
Anmery Varghese, Rajeswari Siva, Thomas V Paul, Kurusilappattu G Selvaraj
DOI:10.4103/IJCN.IJCN_12_19  
Osteoporosis is one of the major qualities of life-threatening diseases affecting women. It affects one in three women over 50 years of age. The aim of the study was to assess the risk factors and knowledge of osteoporosis among pre-menopausal women in selected rural population in Vellore district, Tamil Nadu. A cross-sectional descriptive research design was used to assess the risk factors and knowledge of osteoporosis. A total of 110 samples between 40 and 50 years of age were selected using convenient sampling technique. Data were collected using the Fracture Risk Assessment Tool® by World Health Organisation, International Physical Activity Questionnaire, Food Frequency Questionnaire, 24 h dietary recall and modified Osteoporosis Knowledge Assessment Tool. The mean age of the women in the study was 43.96 years. Majority (98.18%) of the women had high level of physical activity. The mean intake of calorie and calcium were 1630.81 kcal/day and 310 mg/day, respectively. Majority (86.36%) of the women had low calorie intake, and all the women (100%) had inadequate calcium intake. Most (92.73%) of the women had 1%–2% of 10-year probability of major osteoporotic fracture risk and 105 (95.45%) had <0.5% of 10-year probability of major hip fracture risk. Poor level of knowledge was found among (30.91%), 49.09% had fair knowledge, 17.27% had good knowledge and only 2.73% had very good knowledge regarding osteoporosis. There was a significant association between knowledge of women regarding osteoporosis and their education (P < 0.01) and monthly family income (P < 0.01). There was a significant association of 10-year probability of major osteoporotic fracture risk with calcium supplements (P < 0.01). There was a significant association of 10-year probability of hip fracture risk with occupation (P < 0.01). The findings of the study suggest that there is a need to educate women regarding prevention of osteoporosis. Public health strategies should be aimed at improving the calcium intake of women in this age group and to make appreciable lifestyle changes such as reduction in sedentary lifestyle and increased physical activity.
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Effect of a Risk Reduction Intervention Strategy on Caregiver's Knowledge, Attitude and Practice related to Fall Prevention p. 28
Imnainla Walling, Rajeswari Siva, Shandrila G Immanuel, Vinod J Abraham, Mahasampath Gowri, Christy Simpson
DOI:10.4103/IJCN.IJCN_13_19  
Falls are the main cause of morbidity and disability in the older adults. The risk doubles or triples in the presence of history of previous falls. This study aimed to assess the frequency of falls and associated risk factors in older adults and the effect of a risk reduction intervention strategy on knowledge, attitude and practice related to falls prevention among the caregivers of older adults. One group pre-–post-test study design was used. A total of 60 older adults and 60 caregivers were selected using simple random sampling method. Data were collected using the fall assessment questionnaire for frequency of falls among older adults. Majority, i.e., 42 (70%) of the older adults had no fall and 18 (30%) of the older adults had falls during the last 5 years. The overall mean score of pre-test knowledge of the caregiver was 14.08 and the post-test was 37.90, and the difference was statistically significant (P < 0.001). The mean score of pre-test practice was 9.45 whereas the post-test was 17.53, and the difference was statistically significant (P < 0.001). In the current study, 40 (66.7%) caregivers had favourable attitude at both before and after intervention. There was a significant difference (P < 0.001) in the overall mean of existence of short-term modifiable risk factors before and after the risk reduction intervention strategy.
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Knowledge and attitude regarding permanent pacemaker and the quality of life of patients after permanent pacemaker implantation p. 33
Deborah Snegalatha, Jasmin Anand, Bala Seetharaman, Bobby John
DOI:10.4103/IJCN.IJCN_15_19  
Cardiac pacing is an emerging lifesaving procedure that is being widely used in the recent times. Therefore, it is considered vital for the healthcare professionals to be aware of patients' knowledge and experience after the cardiac device implantation and also the impact these implanted devices have on their day-to-day life. This study was conducted with an aim to assess the knowledge and attitude of patients regarding permanent pacemakers (PMs) and their quality of life (QOL) after the permanent PM implantation. A descriptive cross-sectional study design was used in this study. A total of seventy patients were chosen by total enumerative sampling technique among those patients attending the cardiology outpatient department, PM clinic and selected cardiology wards of a tertiary care centre in South India. A knowledge questionnaire, an attitude scale and RAND Short-Form-36 health survey were used to collect data. The mean age of the study patients was 61.71 ± 12.42 years, and 60% accounted for men. The median duration of implantation was 2.9 ± 5.21 years. Majority of the participants (54.3%) had moderately adequate knowledge, 55.7% of the participants had moderately favourable attitude and 46% of them experienced moderate QOL. There were a positive correlation between the knowledge of participants and their QOL (r = 0.340; P = 0.004) and a statistically significant positive correlation between the attitude of participants and their QOL (r = 0.559; P = 0.001). A significant association between attitude and age was found. Conscious effort must be taken to help patients cope better and experience good QOL through systematic teaching after the PM implantation. This will help patients to function maximally and live life to their best capacities in the family and society.
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RESEARCH SERIES NO.19 Top

Data analysis in qualitative research p. 40
Vinitha Ravindran
DOI:10.4103/IJCN.IJCN_1_19  
Data analysis in qualitative research is an iterative and complex process. The focus of analysis is to bring out tacit meanings that people attach to their actions and responses related to a phenomenon. Although qualitative data analysis softwares are available, the researcher is the primary instrument who attempts to bring out these meanings by a deep engagement with the data and the individuals who share their stories. Although different approaches are suggested in different qualitative methods, the basic steps of content analysis that includes preparing the data, reading and reflection, coding, categorising and developing themes are integral to all approaches. The analysis process moves the researcher from describing the phenomenon to conceptualisation and abstraction of themes without losing the voice of the participants which are represented by the findings.
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CONTINUING EDUCATION SERIES NO: 36 Top

Gynaecological cancers p. 46
Diana David, Ebenezer E Benjamin
DOI:10.4103/IJCN.IJCN_3_19  
Gynaecological cancers are cancers of the female reproductive system, mainly including uterine/endometrial cancer, ovarian cancer, cervical cancer, vaginal cancer, vulvar cancer, fallopian tube cancer and trophoblastic tumour. Gynaecological cancers are often detected as a result of general screening procedures. Very few women are compliant with routine examinations; therefore, it is imperative that women are aware of some indicators of these cancers and get help at an early stage if needed. Some of these indicators are unusual bleeding, pain or pressure in the pelvis; unusual vaginal discharge; change in the toilet habits or itching, burning or soreness in the perineum. Treatment depends on the type of cancer, stage, location and general health of the woman. The decision for a single treatment or a combination becomes very challenging, especially when the woman is young and cancer is advanced. Nurses need to be knowledgeable about gynaecological cancers and proficient in caring for women with gynaecological cancers.
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STUDENT SECTION Top

Self-efficacy of patients with stoma in performing stoma care p. 57
Lyshy Mariam Thomas, Ida Nirmal
DOI:10.4103/IJCN.IJCN_2_19  
Persons with stoma (ostomates) have to contend with substantial changes in bowel functions, dietary habits and body image. Adjusting to these changes could be challenging. Effective management of stoma can help this process. A quantitative study was conducted to assess the self-efficacy of stoma care among patients with stoma. Within a descriptive research design, consecutive sampling was used to recruit ostamates for the study. Data were collected using modified stoma self-efficacy scale. Analysis revealed that 56% had moderate self-efficacy and 43.5% had high self-efficacy. Further studies are needed to generalise the findings. Nurses need to be aware that self-efficacy of stoma care among ostomates can influence their quality of life.
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RESEARCH IN BRIEF Top

Distress and coping in cancer patients experiencing chemotherapy-induced alopecia p. 60
Rini Wils, Anandha Ruby Jacob, Emily Susila Daniel, Raju Titus Chacko, S Reka
DOI:10.4103/IJCN.IJCN_4_19  
Alopecia is a major issue related to body image. Hair symbolises life and identity, plays an important role in social communication reflecting the social class, sex, profession and religious belief. Chemotherapy-induced alopecia is a condition that can affect psychosocial well-being and quality of life of a cancer patient resulting in anxiety, depression, a negative body image and lowered self-esteem. This study was designed to assess the level of distress and coping in cancer patients experiencing chemotherapy-induced alopecia. A descriptive study design was used, and a convenience sampling technique was used to select 150 subjects experiencing chemotherapy-induced alopecia in the oncology wards of a tertiary hospital. Chemotherapy-induced alopecia distress scale was used to assess the level of distress and chemotherapy-induced alopecia coping scale was used to assess various coping strategies among subjects. A high level of distress was experienced by 59.3% of the subjects and 60% of them had moderate coping. There was a weak negative (r = −0.083) and a weak positive (r = 0.238) correlation between the level of distress and passive and active coping strategies, respectively. The significant factors associated with distress were gender, financial source for treatment, diagnosis, type of chemotherapeutic drug, number of cycles offered and major coping strategy adopted. Factors such as number of children, family income, duration of illness and occupation of the patient showed significant association with the coping strategies. This study highlighted the need for the health-care team to be more sensitive to the less explored area of cancer treatment which would lead to an improved quality of life throughout the patient's illness process.
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Factors causing stress in midwifery students p. 65
Anne Jarone, Ebenezer E Benjamin
DOI:10.4103/IJCN.IJCN_5_19  
Stress is an emotional and physical strain caused by our response to pressure from the outside world. It is a specific response by the body to a stimulus that disturbs normal functioning. Students are subjected to different kinds of stressors such as the pressure of academics with an obligation to succeed. Students also face social, emotional, physical and family problems. Stress results from the interaction between stressors. Nursing students are likely to experience more stress than their friends and colleagues enrolled in other programmes. This study was conducted among the midwifery students enrolled in the diploma nursing and BSc nursing courses. A self-administered stress questionnaire prepared by the investigator was used to assess the factor causing stress among midwifery students. The study revealed that majority of midwifery students of both diploma and BSc nursing reported high stress related to clinical experience and interpersonal reasons.
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Knowledge and practice on tobacco use in school students, Nagaland p. 69
Achoibam S Singha, Binoty Malandia, Habung Rema, Kelozono Mor, Alem Purnungla Aier
DOI:10.4103/IJCN.IJCN_6_19  
Tobacco use is a leading cause of preventable deaths all over the world, more so in developing countries. The most common reasons cited for children using tobacco are peer pressure, parental tobacco habits and pocket money given to children. The present study highlights the knowledge and practice of school students regarding tobacco in some selected schools in one district in Nagaland. A sample of 325 participants was selected using total enumerative sampling technique. The study findings revealed that the overall knowledge of the students regarding tobacco was 62.25% and practice of tobacco use was 57.2%. The knowledge and practice was found to be statistically significant (P < 0.05). There was statistically significant association between practice and gender (P < 0.05) and type of schools with knowledge (P < 0.05). This study clearly indicates the need for primary prevention of tobacco intake/use as an important part of health education to schoolchildren to assist the students to understand the consequences of tobacco and thereby prevent the consumption of tobacco.
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A comparative study on quality of life of older adults p. 73
Lidziisa Mao, Kasturi Mondal, Madhushree Manna
DOI:10.4103/IJCN.IJCN_7_19  
Old age is a critical period which requires special attention in adapting to the changes of life. A descriptive comparative research study was conducted to assess the quality of life (QOL) and its components among the older adults staying in old-age home and staying with family in selected area of Kolkata, West Bengal. A total of 100 senior citizens above the age of 60 years were selected as samples for the study, of which 50 were from old-age home and 50 from those staying with family. Standardised tool Short-Form 36 Version 2 - Health Survey and Multidimensional Scale for perceived social support were used to measure the QOL. Descriptive and inferential statistics were used to analyse the data. The study findings showed that there was a significant difference in the mean scores of QOL and the different domains of QOL of older adults staying in old-age home and family at (P < 0.05). Older adults staying in old-age home perceived better QOL as compared to those staying with family.
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