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   Table of Contents - Current issue
Coverpage
January-June 2020
Volume 21 | Issue 1
Page Nos. 0-105

Online since Monday, September 14, 2020

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PREFACES  

Special Issue-celebrating 50 years of Masters in Nursing and 25 years of PhD in Nursing At College of Nursing, CMC Vellore p. 0
Vathsala Sadan
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Preface p. 0
Premila Lee
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EDITORIAL Top

A journey on diffusing qualities of transformational leadership p. 1
Vinitha Ravindran
DOI:10.4103/IJCN.IJCN_81_20  
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GUEST EDITORIALS Top

Move towards virtual learning in the context of COVID-19 pandemic: Opportunities and challenges p. 2
Punitha Ezhilarasu
DOI:10.4103/ijcn.ijcn_83_20  
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Looking ahead - Moving forward p. 4
S Ani Grace Kalaimathi
DOI:10.4103/IJCN.IJCN_82_20  
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CONCEPTS AND ISSUES Top

Nursing research in India: Keeping pace or time to catch up p. 6
Leah Macaden
DOI:10.4103/IJCN.IJCN_41_20  
The paradigms of health research have been constantly evolving, shifting and changing over the years with the implications for nursing research. Nurse academics in India are called to reflect critically on their research engagement and develop strategies to contribute towards an evidence base that is contextually relevant for nursing practice, education and management through collaborative research. The opportunities for health research are varied and multifaceted today ranging from infectious diseases to multimorbidity with significant scope for practitioners and nurse academics to become an integral part of research teams both nationally and internationally to make meaningful contributions. Researchers are required to navigate new frontiers such as interdisciplinarity, patient-public involvement and coproduction in their research to demonstrate impact at the academic, societal levels and beyond. The current digital age requires researchers to upskill their digital literacy to be able to fully exploit the potential that it offers towards global connectivity for interdisciplinary research engagement and knowledge exchange.
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Basic life support for mental health crisis: You can be a hero p. 12
Catherine Poornaselvan
DOI:10.4103/IJCN.IJCN_60_20  
Mental illness is not limited to a certain gender, age, sex, religion or race. However, due to the lack of awareness, acceptance, and education, many people endure symptoms without help and treatment, which can lead to the illness becoming progressively worse. Basic life support for sudden cardiac arrest is a well-known first-aid measure. First aid for a mental health crisis, however, is not widely known or understood. ALGEE a pneumonic for approach, listen, give, encourage and encourage is used as an assessment instrument in mental health first aid (MHFA) training that was first initiated in Australia and is now being provided in many countries globally. The mnemonic is simple to learn, just like Circulation Airway and Breathing for cardiopulmonary resuscitation. Many studies done by MHFA organisations globally show that the information and knowledge ALGEE provides can help nurses, other professionals and interested members of the community to better interact with individuals who have mental health crisis. This article addresses the background, process and outcomes of MHFA.
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Redesigning new staff orientation for oncology nurses at an ambulatory regional cancer centre p. 17
Suganya Vadivelu
DOI:10.4103/IJCN.IJCN_59_20  
Staff orientation plays a vital role in maintaining professional practice. An effective staff orientation for new nurses is crucial for promoting competency in providing care and maintaining optimal patient outcomes. A well-planned orientation programme developed within a specific framework addresses the gaps in general and area-specific knowledge and competency, and includes specific guidelines for assessment and evaluation during and at the completion of programme. The orientation should meet the learning needs of nurses, enabling them to increase their work productivity and improve quality in care. This article is a brief discussion on how a staff orientation programme was redesigned for cancer care at ambulatory settings in Canada.
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CLINICAL ARTICLES Top

Stone bone – Is osteopetrosis as hard as it can be??? p. 20
B Abijah Princy, Selva Titus Chacko, Amalorpavamari Lucas, Merlin Nancy Deepa, R Kripa Dharshini
DOI:10.4103/IJCN.IJCN_43_20  
Bone is a vibrant tissue comprising of osteoblasts and osteoclasts. Osteoblasts synthesise bone matrix, whereas osteoclasts help in bone resorption. Osteopetrosis is a heritable disorder that leads to failure of osteoclasts to resorb bone. This leads to impairment in bone modelling and remodelling as changes occur in the shape and structure of the bone. Nearly 70% of osteopetrosis is caused by genetic mutations of TCIRG1, CLCN7, OSTM1, RANKL, RANK and PLEKHM1 genes. Clinical manifestations range from increased bone density, skeletal fragility, disturbed tooth eruptions to haematopoietic insufficiency, nervous degeneration, mental retardation and developmental delay. Diagnosis is mainly by clinical presentation and radiological findings. Treatment is primarily supportive to stimulate host osteoclasts by administering calcium and Vitamin D supplementation, high-dose calcitriol, joint arthroplasty, interferon gamma 1b and gene therapy. Haematopoietic stem cell transplantation is indicated for severe forms of autosomal recessive osteopetrosis. Infantile and intermediate forms of autosomal recessive osteopetrosis can be fatal if left untreated. This article includes a case report of osteopetrosis with focused nursing care using nursing process approach.
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Community-Based Care of HIV/AIDS-Affected Family in India Using the Behavioural System Model p. 27
Greeda Alexander, Mary Narayan, Vathsala Sadan
DOI:10.4103/IJCN.IJCN_42_20  
HIV/AIDS infection is a major public health problem in India. Indian community health nurses assume a major role in the care of people with HIV/AIDS. This article provides a brief overview of the HIV problem in India. It illustrates how a partnership between an Indian community health nursing department in a college of nursing and the community they serve addresses the community's HIV/AIDs care needs. Using a case study of a husband and wife, both infected with AIDS, the article follows how community health nursing staff, faculty and students effectively used the Johnson's Behavioral System Model to assess the couple's needs and develop a care plan that allowed this couple to meet their mental and physical health needs over a 10-year period within the community. The four concepts of the nursing metaparadigm with relevance to the Johnson's Behavioral System Model are also discussed.
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RESEARCH ARTICLES Top

Factor analysis for academic dishonesty tendency scale: Validation for Indian context p. 32
Emily Susila Immnauel, Angelin Esther, Sheeba Rani, Mythily Vandana Charles, Selva Titus Chacko, Grace Rebekah
DOI:10.4103/IJCN.IJCN_44_20  
Honesty and integrity are highly valued qualities in a nurse. However, academic dishonesty has been a concern in nursing education consistently. A nursing student who exhibits dishonest behavior in classroom has a tendency to be also dishonest in clinical practice which can lead to adverse patient outcomes. There is paucity in studies on academic dishonesty among nursing students in India. There is also very limited evidence on which scale is valid or suitable to explore academic dishonest behaviours in an Indian setting specifically among nursing students. This paper addresses this gap by validating the suitability of the 'Academic Dishonesty Tendency Scale developed by Eminoglu and Nartgun to determine the tendencies of University students towards academically dishonest behaviors ' for a population of nursing students in India. 249 students enrolled in III and IV year BSc Nursing and I and II year MSc Nursing programmes in a private college participated in the study and filled the Academic Dishonesty Tendency Scale. The responses of the participants were subjected to factor analysis with Principal Components Analysis (PCA) with Varimax rotation and Kaiser normalization. Exploratory factor analysis was done to assess the applicability of the scale in the Indian setup. The three factors identified- Tendency towards Cheating, Tendency towards Carelessness and Tendency towards Plagiarism were found to be important aspects of academic dishonesty and are very relevant to nursing students. The findings confirm that the Academic Dishonesty Tendency Scale is a useful tool to identify tendencies towards academic dishonesty among nursing students in Indian settings.
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Effectiveness of early initiation of breastfeeding on maternal satisfaction with breast feeding among women who have undergone caesarean section and the breastfeeding behaviour of their newborns p. 38
Rachel Babu Kutty, Ebenezer Ellen Benjamin, Elsy Thomas, Tunny Sebastian
DOI:10.4103/IJCN.IJCN_46_20  
Caesarean sections (CSs) are on a rise globally, with the aim of improving the maternal and newborn outcomes. However, separation of the mother and the baby after caesarean is the most common problem encountered. This is found to be a barrier to early initiation of breastfeeding after CS. An experimental study was conducted to determine the effectiveness of early initiation of breastfeeding on maternal satisfaction and the breastfeeding behaviour of the newborns. A total of 80 women and their newborns were recruited and randomly allocated to experimental group and control group. Breastfeeding was initiated for the experimental group in the recovery room, while for the control group it was initiated in the postnatal ward. The breastfeeding behaviour was assessed using the Preterm Infant Breastfeeding Behaviour Scale, a standardised tool, at the first and second breastfeeding sessions. Maternal satisfaction was assessed using the Maternal Breastfeeding Satisfaction Scale developed by the investigator. The experimental group showed significantly better breastfeeding behaviour than the control group at the first and second breastfeeding after birth with a statistical significance of P < 0.05 the first time and P < 0.001 for the second time. The mean score of maternal satisfaction of breastfeeding amongst women who belonged to the control group was 33.8 as compared to the mean score of 44.07 in the experimental group and the difference highly significant (P < 0.001). Hence, early initiation of breastfeeding is necessary to improve the maternal satisfaction and the breastfeeding behaviour of the newborn
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A randomised control trial to evaluate the effectiveness of sensory integration therapy on motor activity amongst children with intellectual disability p. 44
TM Assuma Beevi, M Nimya, Elizabath K Xavier
DOI:10.4103/IJCN.IJCN_45_20  
Children with intellectual disability across the world are facing several issues. In most situations, they have problems in motor activities such as sitting, lying, walking, jumping and crawling. Many therapies have been researched for improving the quality of life of these children. Sensory integration therapy (SIT) is one of the many therapeutic modalities used for promoting motor activity in these children. The aim of this study was to evaluate the effectiveness of SIT on motor activity amongst children with intellectual disability. A randomised control trial design was adopted for the study. Sixty children who fulfilled the inclusion criteria were selected and randomly allocated to the experimental and control groups. A structured observational checklist for motor activity assessment was used to collect the data and analysed using SPSS software version 17. The results of the study revealed a significant improvement (P < 0.01) in the level of motor activity amongst children in the experimental group after SIT. SIT is found to be effective in improving the motor activity of children with intellectual disability. However, the study can be replicated with large samples to enable generalisation of findings.
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Is what is known enough? Knowledge, perception and competencies on reproductive and sexual health issues of nursing students from a Metropolitan City, Karnataka p. 50
Maryann Washington, Sharon Hartley, Jennifer Tavares, Mercy Pushparaj, Sumithra Selvam, Prem K Mony
DOI:10.4103/IJCN.IJCN_47_20  
Nurses, by nature of their training and experience, are expected to be proficient in addressing sensitive issues, including reproductive and sexual health (RSH). However, health-care professionals are known to struggle with their personal and professional views with respect to these concerns. It is important to determine what young nursing students know and perceive about RSH issues and how they assess their own abilities to address these issues. Cross-sectional sample of 723 1st year nursing students of the undergraduate and diploma programmes, enrolled in eight institutions in a metropolitan city in Karnataka, South India, were selected purposively for this survey. Data were obtained through a self-administered questionnaire under four main sections as follows: (i) baseline information of the student; (ii) assessment of knowledge on 'growing up issues', 'prevention of pregnancy' and 'sexually transmitted infections including HIV;' (iii) understanding perceptions of students on RSH and (iv) self-assessed competency of students. Overall knowledge scores of students were below average (<50%). Responses of students to statements related to their perceptions indicated they required clarification on various RSH issues. Students assessed their personal and professional competency to deal with RSH issues, as a little above average (56%). Cognizance of these gaps in knowledge, perceptions and self-assessed competency on RSH issues of 1st year nursing students, necessitates educators to address these gaps early in their program as they, within 6-month of being enrolled for nursing, have clinical and community postings for a considerable duration of time.
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Effect of perceived social support on stress, anxiety and depression among Nepalese nursing students p. 59
Priscilla Samson
DOI:10.4103/IJCN.IJCN_8_20  
High levels of stress, anxiety and depression can adversely influence physical health, psychological well-being, academic and clinical performance of the nursing students. Social support serves as a buffer against life stressors and improves individuals' psychological well-being. The aim of this quantitative cross-sectional study was to examine the effect of perceived social support on stress, anxiety and depression among Nepalese nursing students. A descriptive cross-sectional study was done among 680 female nursing students enrolled for Bachelor of Science in Nursing program in nine colleges in Kathmandu valley. Depression Anxiety Stress Scale-21 was used to assess the levels of depression, anxiety and stress, whereas perceived social support was measured using Multidimensional Scale for Perceived Social Support. About half the proportion of students reported moderate to extremely severe levels of stress (47%). Majority reported moderate to extreme anxiety (72.9%) and depression (51.7%). Most students perceived high-level social support (68.9%) from family, friends and significant others. A one-way multivariate analysis of variance revealed that perceived social support had a significant effect on stress, anxiety and depression among Nepalese nursing students (Wilks' ƛ = 0.97, F (3, 676) = 8.1, P 0. 000). A discriminant analysis indicated that depression demonstrated the strongest relationship (0.95) with perceived social support contributing to the significant overall effect. The study revealed a strong relationship of perceived social support with stress, anxiety and depression among nursing students. Although most students reported high level of perceived social support, they experienced high levels of stress, anxiety and depression. Hence, the college administration should take the initiative to introduce and implement periodic mental health screening, counselling and referral services.
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Effectiveness of video instruction on anxiety, knowledge of procedure and quality of bowel cleanliness among patients undergoing colonoscopy p. 64
Malathy Murugesan, Jasmin Anand, Sheela Durai, Amit Dutta, Gowri Mahasampath
DOI:10.4103/IJCN.IJCN_49_20  
Inadequate bowel preparation for colonoscopy can lead to increased procedural time, decreased diagnostic yield and an increase in complication rate. Fear, anxiety and lack of information reported by patients are barriers for optimal colonoscopy screening procedures. The successful outcome of colonoscopy procedure depends on how well the colon is prepared enhancing accurate visualisation. This study intended to determine the effectiveness of video instruction regarding bowel preparation on anxiety, knowledge of procedure and quality of bowel cleanliness among patients undergoing colonoscopy. Using quantitative approach, an experimental study was undertaken for 6 weeks. One hundred and twenty patients undergoing colonoscopy were selected using consecutive sampling techniques and were randomly allocated to the control and experimental group. State trait anxiety inventory, knowledge questionnaire and the Boston bowel preparation scale were used to collect the data. The experimental group received the video-assisted teaching on bowel preparation and the control group received the standard teaching. The quality of bowel cleanliness was found to be excellent in 25% of patients in the control group and 75% of patients in the experimental group. There was a significant decrease in the mean score of anxiety level from 45.05 to 34.40 in the experimental group. The study revealed that there was a significant relationship between knowledge of procedure and quality of bowel cleanliness in the experimental group (r = 0.35, P < 0.001). There was an increase in the knowledge of patients, which corresponded with a better quality of bowel cleanliness after the video instruction. Nurses play an important role in patient outcomes during the diagnostic procedure. This study shows that teaching with appropriate aids such as video relieves anxiety, improves knowledge and also improves outcomes in patients. It enhances the excellent quality of bowel cleanliness and aids in accurate diagnosis.
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Effectiveness of a structured teaching intervention regarding the management of side effects of antipsychotic drugs on the severity of side effects among in patients in a tertiary care hospital, South India p. 70
AO Nukshijungla, Helen Sujatha Charles
DOI:10.4103/IJCN.IJCN_50_20  
The discovery and use of antipsychotic drugs in the management of psychotic illness has become a boon for the patients as well as for the family members. However, unwanted but expected side-effects can have a detrimental impact on the consumers of such drugs. This study is aimed to assess the severity of side-effects of antipsychotic drugs and the effectiveness of a structured teaching intervention on patients' management of selected side-effects of antipsychotic drugs. A total of 40 patients were enrolled in the study. The results before the teaching intervention showed that there were patients who experienced 'low' to 'very high' side-effects of antipsychotic drugs, as measured by the standardised study tool, Liverpool University Neuroleptics Side Effects Rating Scale. There was a high reduction in the severity of the side-effects of antipsychotic drugs, and patients were experiencing only 'low' to 'moderate' side-effects after the structured teaching intervention Thus, the study findings suggest that health-care providers needs to continuously monitor the side-effects and provide relevant heath teaching to the patients so that there is high compliance to the treatment and thereby improving their quality of life.
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RESEARCH SERIES Top

Quality in qualitative research: An overview p. 76
Devakirubai Earnest
DOI:10.4103/IJCN.IJCN_48_20  
The issues surrounding the quality of qualitative research are many, and there are different perspectives to the same. This has led to the proliferation of terminologies, criteria and frameworks to judge the quality, which causes confusion for novice qualitative researchers. This article highlights the following: (1) three issues in the quality of qualitative research (rigour and validity versus trustworthiness, generic standards versus tradition specific standards, and the process evaluation versus post hoc evaluation); (2) Lincoln and Guba's qualitative framework and (3) quality enhancement strategies.
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CONTINUING EDUCATION SERIES Top

Continuing education series Coronavirus Disease 2019 (COVID-19) p. 81
Mary Johnson, Jessy Chetty, Ida Sweetlin Priyadarsini, Dinesh Kumar Suganandam
DOI:10.4103/IJCN.IJCN_80_20  
The coronavirus disease 2019 emerged as an epidemic in Wuhan, China, in December 2019 and has exponentially extended into a global pandemic in 2020. As a highly contagious disease, it has forced individuals, communities and countries to take various steps to combat the spread. Although majority of the affected individuals suffer with mild-to-moderate symptoms, the infectious nature, the wild spread and the fatality rates in many countries have led to implementing protocols and procedures applicable to emergency situations. Testing, contact screening, quarantining contacts and isolation and treatment of infected individuals along with measures to control spread are all have been the specific measures mandated globally. This continuing education article highlights the different aspects of coronavirus infection.
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STUDENT SECTION Top

A community project on knowledge regarding COVID-19 p. 96
Abhisikta Samantroy, Amy John, Andrea Tresa Lobo, Angeline Kiruba, Anuja Joy, J Anutza Praisy, Balakyrkhu Marbaniang, S Benisha, Betty Benny, Blessy Roy, Blessy Selina, Blessy Thomas, Prema Suresh, PM Anulin Blessy
DOI:10.4103/IJCN.IJCN_62_20  
Coronavirus infection is a highly contagious infectious disease that has an affinity to the respiratory system and causes pneumonia-like illness in humans. The spread of infection can be prevented by practices such as social distancing, wearing a mask and washing hands frequently. Community participation is a key to controlling the spread of infection. This project was carried out by 12 nursing students in their final-year Baccalaureate programme with the help of their faculty supervisor with an aim to bring awareness in the community regarding COVID-19. The project involved five steps such as orientation to the community of interest, pre-assessment of knowledge on COVID-19 infection in the sample population, leaders' meet, mass health education and family education and post-assessment of knowledge on COVID-19. The community in the selected area had an overall population of 5084. A total of 120 families were conveniently chosen for survey on knowledge regarding COVID-19 infection. The pre-test analysis revealed that 50.8% of the respondents had adequate knowledge. Following the pre-test with the community leaders' support, a mass health education programme was conducted. In the post-health education assessment, 80.5% of the respondents demonstrated adequate knowledge regarding COVID-19 infection. The community project assisted the students to effectively plan and meet the knowledge needs of the community and also enriched their community health nursing learning experiences.
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The knowledge and attitude towards anaemia amongst adolescent girls p. 100
M Dhivakar, M Iswariya, Ponnambily Chandy Jobin
DOI:10.4103/IJCN.IJCN_30_20  
General daily iron requirement expands 2–3 folds during adolescence because of high development spurt and the loss of 12.5–15 mg iron every month during menstruation. Therefore, adolescent girls are vulnerable for iron deficiency anaemia if dietary intake is not sufficient to meet the demands. Thus, the investigators wished to conduct a study to assess the knowledge and attitude towards anaemia amongst adolescent girls in Kanchipuram district, Tamil Nadu. A descriptive research design was used. The population was adolescent girls in the age group of 18 and 19 years, and the sample size was 40. Simple random sampling was used to select the samples. A knowledge and attitude questionnaire developed by the investigators was used to collect data. The study findings showed that the majority of the study participants had a high level of knowledge regarding anaemia 37 (92.5%) and only 3 (7.5%) participants were having a moderate level of knowledge. However, 31 (77.5%) of the study participants expressed moderate level of attitude and none of them had a high level of attitude towards anaemia. All participants (40 [100%]) stated that the inclusion of iron-rich foods in the daily menu is essential to prevent anaemia. Study findings reveal generally good knowledge and moderately acceptable level of attitude.
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LETTER TO EDITOR Top

Masks: To wear or not p. 104
Thuy Le, Van Lan Hoang
DOI:10.4103/IJCN.IJCN_32_20  
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