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   Table of Contents - Current issue
Coverpage
July-December 2020
Volume 21 | Issue 2
Page Nos. 0-210

Online since Friday, February 19, 2021

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PREFACE  

IJCNE - 20 years of publication Highly accessed article p. 0
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EDITORIAL Top

Active Learning Highly accessed article p. 107
Vinitha Ravindran
DOI:10.4103/ijcn.ijcn_11_21  
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GUEST EDITORIAL Top

Academic publishing and publication ethics: Innovations and challenges Highly accessed article p. 108
Punitha Ezhilarasu
DOI:10.4103/ijcn.ijcn_15_21  
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CONCEPTS AND ISSUES Top

Pandemics and epidemics: Past to present p. 110
Remiya Mohan, Vandna Pandey
DOI:10.4103/IJCN.IJCN_65_20  
Pandemics and epidemics befall almost every decade. History documents pandemics since 430 BC. Each outbreak is suspected to be related to a minuscule creature which is new to the world or with a mutation. In recent years, viruses have caused multiple disease outbreaks leading to significant global public health menace. Although we have moved and reached new heights in modern scientific medicine, there remains a gap in understanding of environmental risk factors, disease pathogenesis and apt approach towards its management. This article outlines the major disease outbreaks that affected global proportions and had a marked impact on the human civilisation, starting with historical outbreak of plague, Spanish flu, severe acute respiratory syndrome, Ebola, Zika, Nipah and Middle East respiratory syndrome to the most recent coronavirus disease 2019.
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Unrecognised roles of nursing professionals and midwives in mitigating COVID-19 pandemic across all spectrum of continuum of care Highly accessed article p. 117
Sukhpal Kaur, Rajavel Saranya, Murugan Sathiabalan, Soundappan Kathirvel
DOI:10.4103/IJCN.IJCN_37_20  
Every year, the World Health Organization (WHO) celebrates World Health Day on 7th April marking the foundation day of the WHO in 1948. The theme for the year 2020 is 'Support Nurses and Midwives' to mark Florence Nightingale's bicentennial year. Globally, the nurses and midwives comprise more than 50% of the health-care workforce. They are one of the important health human resources needed to achieve the Sustainable Development Goal on health and well-being by 2030. The services include promotive, preventive, curative and rehabilitative health-care services covering the whole spectrum in the continuum of care. The midwives primarily provide the primary health-care services primarily at community level. Similarly, various cadres of nurses deliver various healthcare services primarily at the facility level. During the Coronavirus disease- 2019 (COVID-19) pandemic the frontline Health Care Workers (HCWs) like nurses and midwives play a vital role in breaking the chain of transmission and providing supportive care to the suspected and confirmed COVID-19 patients. This manuscript describes in detail, the unrecognised roles of nurses and midwives in prevention and control of COVID-19 across all spectrums of continuum of care. This can be identified at community and health facility level from providing health education or behaviour change communication, screening/surveillance (active or passive), contact tracing, clinical care, mental health support, hospitality services, inventory management, monitoring/supervision of personal protective equipment use and biomedical waste management, isolation ward and quarantine centre management, recording and reporting and follow-up of patient/population.
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CLINICAL ARTICLES Top

Care of patient with carcinoma stomach p. 122
Nicole Johnson, Nirmala Emmanuel, Suganthy Grace, Jeenus Kalaivanan
DOI:10.4103/IJCN.IJCN_128_20  
Gastric cancer is not caused by just a single factor but a combination of genetic, socio-cultural and environmental factors. Stomach cancer can have no outward signs and symptoms in its early stages to varied symptoms in the later stages. The mode of treatment is chosen based on how long one has had the disease or what the stage of the cancer is. After the diagnostic laparoscopy, the patient with the tumor deemed resectable undergoes gastrectomy, if deemed unresectable then undergoes chemotherapy. This paper outlines the nursing care of a patient Stomach cancer.
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Nursing management of patients with violent behaviour p. 129
Jeeva Sebastian, Sudipta Debnath
DOI:0.4103/IJCN.IJCN_129_20  
Violence means the behaviour involving physical force intended to hurt, damage or kill someone or destroy something. Violence is a part of the national mythology. Generally, if something or someone has been harmed, then it is regarded as violence. Violence seen among patients in acute psychiatric setup imposes a greater risk on the staff, other patients as well as the treatment process. Certain psychiatric illnesses such as personality disorders and substance dependence are highly associated with violent behaviour in those patients. Care of such patients and family requires collaboration with various members of the health team. Nurses can play a pivotal role in identifying early warning signs, assessing the risk and in mitigating and managing violent behaviours and situations. The nursing management of a patient with violent behaviour in a mental health facility is discussed in this article.
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RESEARCH ARTICLES Top

Need and relevance for English language training in oral case presentation of student nurses p. 135
Cynthia Milton, M Prabakaran
DOI:10.4103/IJCN.IJCN_20_19  
Oral case presentation (OCP) is an important clinical skill for nurses. Literature shows that, generally, less attention is paid to the development of OCP skills. Most of these studies being done by native English speakers have given importance only to content development rather than English language skills needed for OCP. This article explores the English language difficulty and its associated psychological barriers underneath the presentation of clinical cases of student nurses with limited English proficiency. This descriptive needs analysis study was done amongst the student nurses in South India. It has used a mixed method of exploratory interview and a standardised quantitative tool uniquely designed to bring out the hidden barriers in the effective use of English for OCP. The findings show that the most of the student nurses were not satisfied with their language ability to perform OCP. Amongst the language difficulty, the highest perceived difficulty was related to grammar usage and the inability to correct grammar mistakes, which had a mean value of 5.00 and 4.96, while explaining with good pronunciation had been their next concern with 4.96. The findings show that psychological aspects related to learning of second language influence their OCP skills. This language audit will furnish information on key linguistic skills that need to be focussed while developing English for specific purposes lessons for OCP training. The study will help to bridge the gap between classroom teaching and clinical communication requirement and significantly improve the performance of the English as a Second Language student nurses.
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Effectiveness of simulation-based teaching on manual expression of breast milk among mothers of babies admitted in the neonatal unit, South India p. 143
Jane Emily Beatrice, Ebenezer Ellen Benjamin, Jenny Rajesh, Reeta Vijayaselvi
DOI:10.4103/IJCN.IJCN_137_20  
Feeding sick new born with breast milk is challenging. Mothers of sick infants must express breast milk until their infants are able to feed directly from the breast. Therefore, it is very important to teach the mothers whose babies are admitted in the Neonatal unit about the correct method of manual expression of breast milk. Marmet Hand Expression Technique requires practice, skill and co-ordination. Hence, appropriate teaching method and content is much needed to educate and train the postnatal mothers. The study aims to determine the effectiveness of simulation-based teaching on the manual expression of breast milk. A quasi-experimental research design was undertaken for 6 weeks. Seventy mothers were selected using simple random sampling technique. A knowledge questionnaire and an observational checklist were used to collect data on knowledge and practice from mothers on the Marmet technique of milk expression. Data were collected for the control group with routine teaching in the nursery for the first 3 weeks and the next 3 weeks for the experimental group with simulation-based teaching. Pre-test assessment was made for both groups. Post-test assessment for knowledge was made after 72 h of the teaching. Post-test assessment for practice was made at 24, 48, and 72 h of teaching. The study revealed that there was a statistically significant increase in the knowledge and practice of mothers on the manual expression of breast milk (P < 0.001) in the experimental group. This study identified that simulation-based teaching was an effective teaching tool. Knowledge gained through this research will be used to implement the simulation-based teaching for educating the postnatal mothers on manual expression of breast milk in the Neonatal unit.
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Psychometric properties of diabetes attitude measurement scale among patients with Type 2 diabetes p. 150
Athirarani Muraleedharan Rohini
DOI:10.4103/IJCN.IJCN_131_20  
Attitude towards the disease is an important determinant of better outcomes in patients with diabetes. It has wide-ranging effects on drug compliance, dietary modifications, self-care and frequency of follow-up. There was no tool in the local language to assess attitude towards disease among diabetes patients comprehensively. The present study intended to assess the psychometric properties of Diabetes Attitude Measurement Scale (DAMS) among patients with Type 2 diabetes mellitus. A purposive sample of 242 individuals with diabetes was included for validation purpose. A 30-item questionnaire, to identify the attitude towards the diabetes was developed in the local language, by selecting items through literature search, expert opinions and qualitative methods such as in-depth interview and focus group discussions. Item reduction was done by expert opinion based on the endorsement rate and pilot testing and the items were reduced to 22. The psychometric property of the tool was assessed by factor analysis among 242 patients with Type 2 diabetes mellitus. The final questionnaire had 16 items questionnaire with internal consistency reliability of 0.77 and cumulative variance of 60%. DAMS has adequate psychometric properties to identify attitude towards disease among patients with Type 2 diabetes. The most important clinical implication of tool is that it can be incorporated for the assessment of determinants of glycaemic control.
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Impact of an educational programme on knowledge on breast cancer and practice of breast self examination among women p. 155
Nema Ram Gurjar
DOI:10.4103/IJCN.IJCN_18_19  
Breast self-examination (BSE) is important for early detection of breast cancer. Women need to have appropriate knowledge and practice regarding BSE. Irrespective of many awareness programme for prevention of breast cancer, the knowledge and practice regarding BSE among women are still poor. This study aimed to assess the effectiveness of health education programme on knowledge on breast cancer and practice of BSE among women. A pre-experimental research design was used. A total of 40 women were recruited by convenient sampling technique. Data were collected using an instrument with 20 knowledge and 7 practice questions before and after the Health Education programme on BSE. The findings revealed that the knowledge on breast cancer and practice scores on BSE were poor at pre-test and improved significantly after an educational intervention. Findings concluded that the educational programme was helpful in increasing knowledge and practice of BSE among women. Education programme is important to create awareness among women regarding BSE and needs to be continued to help women in prevention and early detection of breast cancer.
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Impact of a Case-based–Team-based learning model on critical thinking and self-efficacy of nursing Undergraduates in China p. 159
Yuexia Liao, Sumei Wang, Dezhen Weng, Ting Han, Yiyun Yang, Rong Chen, Xinxin Sun
DOI:10.4103/IJCN.IJCN_51_20  
Different education systems or cultural backgrounds may influence the effectiveness of various educational approaches. The purpose of this article is to report the impact of an integrated case-based and team-based learning (CB-TBL) approach on critical thinking, self-efficacy and learning interesting of nursing undergraduates. We conducted quasi-experimental and qualitative study on 118 nursing undergraduates from 20 teams who were taking a course on nursing management from September 2017 to January 2018. The teams researched their assigned topics, identified a case study, carried out the investigation, created PowerPoint presentations, reported and discussed the topic and posted them on the course management system blackboard site. Data gathering was based on two valid and reliable questionnaires: Chinese version of the Critical Thinking Disposition Inventory (CTDI-CV) and the Self-efficacy Integrated Scale. Open-ended questions were also designed for the evaluation of students' feedbacks and views on educational methods. The results showed that more than 90% of participants found the CB-TBL model interesting. We found that the post-test average score was higher than the pre-test one in the CTDI-CV, the General Self-Efficacy Scale and the Academic Self-Efficacy Scale. The participants and teaching supervision team also responded positively to the CB-TBL approach, which greatly stimulated the students' learning interest. This article may be of value to nursing educators who wish to replace traditional learning with informal learning (student-centred active learning) so as to enhance not only the students' knowledge but also the advancement of critical thinking and self-efficacy.
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Effectiveness of quick relaxation technique on pain associated with chest tube removal among postoperative coronary artery bypass grafting patients in a Tertiary Care Hospital, Delhi p. 166
Jilmy Anu Jose
DOI:10.4103/IJCN.IJCN_134_20  
The current burden of coronary artery disease in India is >32 million. Chest tube removal (CTR) is a common procedure in critical care units and post coronary care units and is associated with moderate-to-severe pain. The pain management protocols remain unsatisfactory for most patients and researchers recommend the development and introduction of new protocols. Even with pharmacological management, most patients remember chest removal as a painful and discontented moment. Advanced practice nurses remove chest tubes most often. The aim of the present study was to assess the effectiveness of quick relaxation technique (QRT) on CTR for reducing the pain levels experienced by patients and also adopting it as a routine practice in cardiac surgical units. An experimental design was used. Sixty patients who were posted for coronary artery bypass grafting (CABG) were selected using purposive consecutive sampling method and randomly allotted to the experimental and control group. QRT was implemented to experimental group patients along with the regular protocol before drain removal. Control group patients underwent the regular protocol followed in surgical intensive care unit. The structured assessment tool was developed and used for data collection, which consisted of demographic data, information related to chest tube and numerical rating scale for pain assessment. Out of the 60 patients majority were in the age group of 60–70 years and majority were male in the control and experimental groups. Control group had mean post-procedure pain score of 5.1 ± 1.14, whereas the experimental group had mean pain score of 3.7 ± 1.05. QRT was highly effective in reducing the pain level on chest tube drain removal of post-CABG patients (Unpaired t-test value of 5.6394 with df 58, P < 0.0001). The study will be useful in identifying QRT as an important intervention in reducing pain associated with CTR. QRT can be used as a routine practice before CTR in the cardiac surgical unit. Hospitals and nursing institutes should prepare guidelines for QRT along with routine pharmacological management during CTR for better patient satisfaction.
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A Study to assess stress and stressors among Undergraduate nursing students in a selected college at Mangaluru p. 171
Ashel Christal Pinto, Ashly Francis, Armin Rose Sabu, Asha Biju, Ashly James, Precilla D Silva
DOI:10.4103/IJCN.IJCN_133_20  
Stress is a specific response to the stimulus that disturbs the normal body functions. Stress affects the academic performance and welfare of nursing students. The aim of this study was to identify the severity of stress and the stressors among undergraduate nursing students. Two hundred students in the nursing programme in a college completed a survey on stress and stressors. The tool included demographic characteristics, perceived stress scale and a checklist to assess the stressors. The result was analysed using descriptive statistics. Majority of the students (88%) reported moderate level of stress. Large number of the subjects have stress due to less vacation, and the second major stressor was lack of sick leave. Identification of severity of stress and taking measures will improve the students to cope up with the academic and personal issues. The findings of this study can be used to design effective stress management programme for nursing students.
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Birth satisfaction among low risk women in a Public Healthcare Center in India p. 176
Lumchio Levis Murry, Philomina Thomas, Gita Razdan, Ravneet Kaur, Shashi Maward
DOI:10.4103/IJCN.IJCN_21_19  
Women's satisfaction with the care they receive during childbirth has gained importance in recent years. Factors such as women's stress experienced during labour, anxiety and feeling of being in control during labour have not been widely studied in India even though these factors influence satisfaction with birth. This study aims to assess women's satisfaction with care following normal birth in a secondary level public facility using the Birth satisfaction Scale Revised (BSS R). Consecutive samples of 273 low risk women who have had spontaneous vaginal birth were enrolled within 1 week of childbirth. Demographic profile was collected, and women were assessed for satisfaction at birth using the BSS R. The total birth satisfaction score was 21.4 (±4.5), which is just around the mean of the total score. The women scored below average in the sub domain of stress experiences during labour (7.0 ± 2.6). The domain on women's' personal attributes was also rated poorly (2.8 ± 1.5). The quality of care provision was rated above average by the women (11.6 ± 2.7). A significant difference in the mean score of BSS R was seen in relation to educational status of the women and the type of family they belonged to (P < 0.05). Assessment of birth satisfaction can assist in focusing on areas where improvement in care is required. Midwives need to educate and partner with women right from the antenatal period to make labour and childbirth a satisfying experience for the woman.
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Effectiveness of hot water footbath therapy in reducing body temperature amongst patients with fever p. 181
M Muthupriya, R Lakshmi
DOI:10.4103/IJCN.IJCN_19_20  
Fever has been recognised as a symptom and not a disease in itself. The thermoregulatory centre in the hypothalamus regulates body temperature. Hydrotherapy in the form of cold and tepid applications has been historically used for reducing increased body temperature. Many studies have looked at effect of hydrotherapy over pharmacological measures and have found that tepid or cold sponging reduces body temperature rapidly, but are associated with discomfort for the patients. There is some evidence that hot water soaks to foot reduces body temperature effectively. Hot water footbath is considered as a non-pharmacological, safe, side effect-free, cost-effective and easy-to-administer therapy to reduce fever. The aim of this study was to assess the effectiveness of hot water footbath therapy (HWFBT) in reducing the body temperature in adult patients with fever. Sixty patients were selected by convenient sampling technique, of which thirty patients were allotted to experimental group and thirty to control group by random method. HWFBT was given to experimental group. The control group received the standard care as per practice of the hospital. The findings showed that the difference in the mean body temperature in the post-test was significantly lower in the experimental group (P < 0.001). HWFBT may, therefore, be effectively used as an intervention to reduce the body temperature in patients with fever.
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To assess the effectiveness of simulation teaching of defibrillation on the knowledge and skill of nurses working in the critical care unit of a Tertiary Care Teaching Institute: Prospective, randomised study p. 185
Devanshi Chowdhary, L Gopichandran, Rakesh Garg, Dalim Kumar Baidya
DOI:10.4103/IJCN.IJCN_31_20  
Rapid defibrillation is a life-saving treatment for pulseless ventricular tachycardia and ventricular fibrillation which are the most common cardiac cause of sudden death. Simulation teaching has been shown as an effective teaching method for nurses. The present study was conducted to assess the effectiveness of planned simulation teaching regarding defibrillation on the knowledge and skill of nurses working in the critical care unit and emergency department of a tertiary care hospital. A randomised control design was used in which 100 nurses from the emergency department and critical care unit were randomly assigned to the experimental and control group. Baseline knowledge and skill were assessed using an investigator developed defibrillation knowledge assessment questionnaire and defibrillation skill assessment checklist, respectively. Simulation teaching was given in the experimental group. The simulation teaching was provided in the clinical area in a group of 3–4 nurses. Post-test 1 was taken immediately after the simulation teaching in the experimental group. Post-test 2 was taken after 1 month of enrolment in the study in both the groups with the same tool. A significant improvement in knowledge and skill was observed in the experimental group. A significant association of pre-test knowledge with gender, age, educational qualification, education program attended, experience with defibrillation and of the post-test knowledge with gender, nature of work, experience with defibrillation, educational qualification and age were found. A significant association of pre-test skill with nature of work and post-test skill with gender and nature of work was also found. A significant moderate positive correlation (r = 0.42) was found between the knowledge and skill on nurses. Simulation teaching is an effective method for increasing knowledge and skill among nurses. The present study has further opened up new avenues into nurse-led defibrillation initiatives in India.
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Building blocks: The art and science of searching the literature p. 193
Sheela Durai
DOI:10.4103/IJCN.IJCN_140_20  
The universal phenomenon of 'search' plays a significant role in the process of review of literature. When review is carried out as part of research, the search for literature itself is to be done methodologically and systematically, turning the process of search into a science. Formulation of the search strategy is the most significant step which will direct the course as well as the content in the review of literature and needs to be given a lot attention. This article introduces scientific literature to the nurse researcher and elaborates on the building blocks of the stages of search, such as identification of search approach, databases, terms/phrases, areas/fields, search operators and search limits. When a nurse researcher gets familiar with the search styles and tactics of scientific literature, he/she realises that literature search is an art and science of building search blocks effectively with much strategising.
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CONTINUING EDUCATION SERIES NO: 39 Top

What is team-based learning, and how is it used in nursing? p. 198
Annetta Dolowitz
DOI:10.4103/IJCN.IJCN_8_21  
Team-based learning (TBL™) is an active learning and teaching strategy where students have an active role in their learning. It is a method where the instructor facilitates learning, not lecture from the front of the room. TBL™ is also a very structured teaching strategy based on cognitive learning theory. Team formation, readiness assurance process, application activities and peer evaluation are the four pillars of TBL™. TBL™ has become popular and is a preferred teaching method in nursing education in many institutions. The aim of this article is to introduce the process of TBL™ and discuss its use in nursing.
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STUDENT SECTION Top

Assessment of aggressiveness amongst young adults during COVID-19 Lockdown, Tamil Nadu, India p. 206
M Priya Dharshini, U Nantha Kumar, A Gnanaprakash, S Vijaya Lakshmi, Cynthia Mary Cherian, Rogina J S. Savarimuthu
DOI:10.4103/IJCN.IJCN_88_20  
COVID-19 is a pandemic disease caused by coronaviruses. Feelings of frustration and agitation have increased aggression, trauma and violence due to lockdown. An e-survey was conducted to assess aggressiveness amongst young adults during lockdown in Tamil Nadu, India. The objectives were (1) to assess aggression amongst young adults during lockdown and (2) to associate aggression amongst young adults during lockdown with their demographic variables. Majority of the respondents reported moderate aggression and moderate level of physical aggression, verbal aggression, anger and hostility. Type of stay was found to be significantly associated with aggression in general and physical aggression in specific. Quality family time was found to be significantly associated with verbal aggression. Family type was found to be significantly associated with hostility.
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EVIDENCE BASED GUIDELINES Top

Evidence Based Guidelines p. 209
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