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音量 4, 問題 3 (2015)

研究論文

Assessment of Nurses’ Preparedness and Identify Barriers to Care Women Exposed to Intimate Partner Violence in East Gojjam Zone, Ethiopia, 2014

Haymanot Zeleke, Daniel Mengistu and Girma Alem

Introduction: Intimate partner violence (IPV) is a pattern of purposeful coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation. This violence can be considered a leading public health problem with serious health consequences for Women exposed to IPV. Due to, the nurse is often an early point of contact, no information of nurses’ preparedness regarding to IPV care in Ethiopia, high prevalence and impact on women health, these make it problematic. Method: descriptive correlational quantitative study design was conducted to assess nurses’ preparedness (knowledge, practice and attitude). Required sample size was 448 nurses. From 18 woreda, nine woreda were randomly selected through proportionate sampling method then the study sample was selected randomly. Odds ratio, 95% confidence intervals and 0.5% marginal error was used. Descriptive, bivariate and multivariate analysis was conducted. Result: Just over 94% of all respondents had not received any training. More than the halves of nurses were not knowledgeable. Around 60% of nurses had negative attitude to IPV cases. In addition, almost 60% of nurses were not skilful. There was a significant association between being male to care to Women exposed to IPV. Males were around 8 times more likely to give care to Women exposed to IPV. Nurses who had experience on the care of women exposed to IPV were more give care than who never had experience. Conclusion and recommendation: Many of nurses had no skill/experience to care women exposed to IPV and majority of nurses could not ask sign of women exposed to IPV like eating disorders, hypertension, headaches and irritable bowel syndrome. Majority of nurses were not knowledgeable and not skilful.

総説

Sociological Conceptions of Happiness and its Implications for Psychotherapy and Public Policy

Ian Shaw, Hugh Middleton

This paper critiques the usefulness of cognitive-behavioural therapy, which is often seen as a means of redressing the loss of community and friendship networks within society. Therapy in this context they runs the danger of becoming an Iatrogenesis at worst and just another `technology of mood’ at best. In this paper we develop the critiques made elsewhere and provide a more nuanced argument that considers a wider range of psychological therapies. While all psychological therapies operate at an individual level, there are wide differences in the epistemological stances taken by differing therapeutic schools. Cognitive-behavioural therapy focuses on the idea of dysfunctional thinking within the individual, psychoanalytic therapy focuses upon developmental legacies, whereas person-centred therapy focuses on currently active social influences. In this form one to one therapy can be a route to change which is compatible with our sociological critique. However, the broader criticism that psychological therapies attempt to compensate for breakdowns in friendship and social networks remains. Furthermore reviews of psychotherapeutic outcome data and qualitative enquiry both point to the experience of authentic relationship rather than psychotherapeutic technique as the major determinant of outcome. Preventing social dislocation rather than trying to repair it post hoc should be the goal. This would beg a wider range of questions such as; what does social isolation actually mean in contemporary western society and what does this mean for people with mental health problems in particular? What are the various ways in which social networks provide support functions and what may be missing in an individual’s life and then what can be done to try and compensate for that lack?

総説

Benefits and Risks of Disclosing Human Immunodeficiency Virus Diagnosis to Perinatally Infected Children: A Critical Review of the Literature

Chrissie Phiri and Evelyn Chilemba

Disclosure of HIV infection to perinatally infected children is a contemporary issue that demands conscientiousness among health workers in dealing with those affected. This is because of the complicated treatment regimen that prompts questions from the affected children, their parents and of course the caregivers. The aim of the review was to seek evidence from literature regarding the benefits and risks of disclosing HIV status to perinatally infected children in order to influence practice in educating, informing and supporting parents/caregivers in Malawi. The review sought for evidence in order to appreciate the benefits and risks through a critical appraisal of literature and synthesis of the findings of the existing studies. The search strategy was achieved through an electronic data base search of research articles from Medline, Embase and CINAHL. The search strategy was limited to articles published between 1996 to June 2011. These were qualitative studies conducted in Southern Africa and were in English language with relevance as the guiding principle in the search. The review results exposes that parents of HIV infected children experience barriers to disclosure and that stigma is such a major and one of barriers to disclosure and that stigma particularly brings fear among the parents of the children. The fears came about because the children would request to know how they got infected and these type of questions would make parents upset. Therefore, it is postulated that adequate preparation and specific plans of disclosure should be designed before disclosure is implemented. The plan considers issues of age, intellectual abilities and developmental milestones. The ethical issues in giving wrong information, thus the inaccurate diagnosis when the child asked questions regarding their status are dangerous to the child’s compliance to treatment regimen. Despite the secrecy surrounding the affected children’s status, these children ultimately become aware of their problems. In conclusion, some parents of the HIV affected children prefer disclosure of HIV/AIDS status to their children based on age, while others prefer giving them inaccurate diagnosis. It is envisaged that these parents need support to this dilemma from health workers. Support and discussions at convenient times with parents should be considered a major need in the management of HIV/AIDS.

研究論文

Challenges to use Volunteer Counseling and Testing for HIV/AIDS among Jimma University College of Public Health and Medical Sciences Graduating Class Students Jimma, South West Ethiopia, Cross Sectional Study

Mebruka Sahib Bezani, Muluneh Haile and Sena Belina Kitila

Background: HIV/AIDS is a major public health problem, whether by its impact at national, community, and individual level, since the first cases of AIDS report. Volunteer Counselling and Testing (VCT) is the most effective strategy in bringing positive behavioural change on HIV/ AIDS and play an important role in helping people to change their sexual behaviour, reduce HIV transmission. The aim of this study was to assess challenges to use VCT among Jimma University College of Public Health and Medical Sciences Graduating Class Students.

Methods: Cross sectional study with quantitative methods of data collection was employed from April 1st to 15/ 2012 using pre tested self-administering questionnaire was used for data collection.

Result: Data was extracted from 219 respondents that makes response rate 92.02%. Out of the 219 respondents 182 (83.1%) were males, 118(53.9%) were within age group between 21-24 years, majority of respondents 215 (98.2%) were single, 134(61.2%) were Christian by their religion, majority51(23.3%) of the respondents were from Health officer department, 147(67.1%) had get pocket money ≥ to 344 birr and 103 (47.0%) had history of residence change. 68(31.1%) were being tested and 215(98.2%) knowledgeable 137(62.6 %) had positive attitude, 140(92.7%) had willingness to be tested .

Conclusions and recommendations: This study showed low utilization of VCT service VCT service even though majority of respondents had knowledge and positive attitude. The significant predictors’ for its use were: fear of outcome result, community attitude, social stigma, rejection. Willingness to use it has significant association with some of socio demographic characteristics, knowledge and attitude of the respondents. Further prospective studies with both qualitative and quantitative method of data collection is recommended.

解説

Single-Room Neonatal Intensive Care: State of the Practice

Dennis C Stevens

Of the many challenges facing professionals who practice in neonatal intensive care in the United States, the question of what type of facility is optimal has been debated for more than a decade. We have attempted to explore this question at Sanford Children’s Hospital in Sioux Falls, SD. The purpose of this article is to briefly summarize our work and other significant research findings regarding neonatal intensive care unit (NICU) room design. At this time, the single-room NICU is comparable, and possibly superior, to the open-bay NICU with the caveat that the on-going developmental needs of the neonate must be continuously assessed and appropriate interventions applied in their on-going NICU care.

短いコミュニケーション

Evidence Based Patient Education to Promote Natural Childbirth Experiences: Educating your Patients to know the Right Questions to ask to meet their Own Personal Birthing Needs

Erica Sisiam

Nurses need to educate and advocate for women seeking a natural un-medicated childbirth experience. Evidence based practices are difficult to research for a nurse and are often overly complicated preventing application to the average individual’s personalized birthing plan. Increasing educational support and available alternatives allows for informed decision making, and promotes a natural childbirth, which directly improves patient satisfaction. Education needs to start from the point of antenatal care, prior to entering a birthing facility. Hospitals and birthing centres that have more options and alternatives to support natural un-medicated childbirth can additionally increase revenue by becoming a destination facility.

研究論文

Connecting Leisure-Time Physical Activity and Quality of Sleep to Nurse Health: Data from the e-Cohort Study of Nurses and Midwives

Tim Henwood, Anthony Tuckett, Nadja E ?Bagadi and John Oliffe

Background: Professional nurses are prone to fatigue and poor health. Getting sufficient physical activity and sleep have reported benefits. However, the benefit of ample sleep and physical activity to nurse health is understudied.

Objective: The goal of the current article is to report nurse general and workplace health, productivity and wellbeing by comparing those professionals with recommended levels of physical activity and sleep to those with reduced profiles.

Design: Data were generated from the 2006-08 delivery of the e-Cohort survey of nurses and midwives.

Methods: The primary analysis (n=3967) was based on the physical activity and sleep categories: (LS1) Meeting the recommended guidelines or above for both leisure physical time activity and sleep; (LS2) Meeting the recommended guidelines or above for leisure time activity but not sleep; (LS3) Meeting the recommended guidelines or above for sleep but not leisure time activity; and (LS4) Not meeting the recommended guidelines for both leisure time activity and sleep.

Results: LS1 were significantly younger, had a lower body mass index than any other group and were the least likely to report in-work difficulty, emotional barriers to workplace productivity and restriction in basic daily tasks. LS4 were more likely to have osteoarthritis, depression and high blood pressure.

Conclusion: The study findings confirm health benefits from achieving recommended levels of physical activity and sleep. Adherence to beneficial lifestyle behaviours has important implications for the self-health of nurses. Workforce administrators should consider this when designing programs to reduce nurse workplace burnout and aid workforce retention.

研究論文

The Skin Conductance Algesimeter Validated with the Numerical Rating Scale Postoperatively in Patients Treated with Classical Music

Rocco Rago, Paolo Miccoli, Hanna Storm, Francesco Forfori, Francesca Franceschini, Jacopo Belfiore and Francesco Giunta

Background: An inadequate estimation and management of perioperative pain may delay patient recovery and discharge from hospital. For this reason, increasing effort has been put on the identification of both new approaches for pain monitoring and new procedures to reduce pain perception, especially in perioperative patient care: the aim of this study was to evaluate the efficacy of the skin conductance algesimeter index - number of skin conductance fluctuations (NSCF) per second -, as compared to the Numerical Rating Scale (NRS), in perioperative pain monitoring of thyroidectomy patients. Moreover, in the same patients, we investigated the effect of classical music listening on pain perception during the postoperative period.

Methods: Forty patients scheduled for surgical thyroidectomy were randomized into two groups with partially different postoperative managements: Group C (Control) received the traditional treatment, while Group S (Study) had classical music in addition to the traditional treatment. In both groups, the postoperative pain levels were assessed using NSCF per second, NRS and self-administrated analgesic drug consumption.

Results: The C and S groups were characterized by similar levels of pain as measured by NRS and NSCF per second. The S group used less morphine than the C group (0.3 mg vs 1.1 mg; P<0.01). We also observed a significant correlation between NRS and NSCF per second when 30 minute time intervals between measurements were used (R=0.69, P<0.01). On the other hand no correlation was observed when moment-by-moment measurements were used. Both the NRS and NSCF per second decreased significantly during the postoperative period.

Conclusion: The NRS and NSCF per second performed similarly for pain assessment in the postoperative period. Classical music listening in addition to traditional treatment reduced the morphine consumption without clearly influencing the pain level as measured by NRS and NSCF per second.

研究論文

The Influence of Social Media on Sleep Quality: A Study of Undergraduate Students in Chongqing, China

Xiang-Long Xu, Run-Zhi Zhu, Manoj Sharma and Yong Zhao

Objectives: We aimed to identify the influence of using social media on the sleep quality of undergraduate students in Chongqing, China. Methods: A cross-sectional study was performed on undergraduate students in Chongqing, China. A multistage stratified sampling was adopted. The study population was composed of 1,444 (72.97%) females and 535 (27.03%) males. Results: More than half of undergraduates who used social networking service websites (66.25%), Fetion (82.68%) microblogs (66.43%), QQ (66.38%), WeChat (63.56%), post bars (62.89%), forums (58.70%), SNS website (37.30) and blogs (27.00%) reported poor sleep quality. We found respondents who were from university of foreign languages or used WeChat were less likely to have poor sleep quality. Further, undergraduates who spent 0.5 to 2 hours before bedtime or above per day on social media were more likely to have poor sleep quality. Conclusions: More than half of undergraduates who use social media experience poor sleep quality. Undergraduates at University of Foreign languages may be less likely to experience poor sleep quality. Using WeChat may be less likely to experience poor sleep quality.

ミニレビュー

Role of Care for the Prevention of Falls and Fractures among Elderly Persons Living in Long-Term Care Facilities

Tatsuya Koike

Osteoporosis is the most important disease, along with cognitive disorders, in the aging society, especially in developed countries. Residents of long-term care facilities are a high-risk population for falls and fractures because of their frailty and cognitive disorders. People with internal or external risk factors might fall more frequently. Internal risk factors are endogenous features of each individual, most of which cannot be altered by intervention. On the other hand, external risk factors are environmental conditions, which can be easily modified in many cases. After a fall, the individual suffers an impact force. To reduce this impact force is an alternative measure to prevent fractures, not falls. As an internal risk factor for fracture, bone mineral density (BMD) might become a target for treatment. For that purpose, we have several effective medicines to increase BMD and reduce fracture rates. The most important thing is that caregivers in long-term care facilities develop a better understanding of risk factors for falls and fractures to reduce fall-related injuries of residents.

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