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音量 8, 問題 2 (2019)

研究論文

Knowledge and Attitude of Nurses towards Palliative Care in Government Hospitals of Addis Ababa, Ethiopia

Sisay Gedamu, Emebet Berhane, Abebe Dires, Samuel Anteneh, Debrnesh Goshiye and Lehulu Tilahun

Purpose of the study: To provide clear findings regarding knowledge and attitude towards palliative care with its associated factors which may help to show direction to solve problems based on the result.

Methods: An institution based cross-sectional study was conducted among 426 nurses in four randomly selected government hospitals in Addis Ababa. To select the study participants, the total sample size was allocated proportionally to each selected hospitals. Again proportional allocation was done for each work area in each selected hospitals. Finally from each work areas, nurses were selected by using a systematic random sampling method to attain the final individuals. The knowledge and attitude of nurses towards palliative care was measured using questionnaires which are adopted and modified from the Palliative Care Quiz for Nursing and Frommelt Attitude toward Care of the Dying scale, respectively. Epidata 3.1 and SPSS version 23 software were applied for data entry and analysis respectively.

Result: The response rate was 92.02% of the total participants. Study results had shown that only 104 (26.5%) of the respondents had good knowledge and 331 (84.4%) had favorable attitude towards palliative care. Level of Education, working department, years of working experiences in nursing, experience in caring chronically ill patient and in-service training of palliative care had significant association with the knowledge of nurses towards palliative care. Level of education, experience in caring chronically ill patient and in-service training were found to be statistically significant with the attitude of nurses towards palliative care.

Conclusion: Nurses had poor knowledge but their attitude towards palliative care was favorable. Attention should be given towards palliative care by the policy makers and palliative care to be incorporated in nursing education. On job training for nurses working in hospitals should be provide.

研究論文

Assessment Levels of Some Electrolytes in Hypothyroidism Patients

Salim Hussein Hassan, Ahmed Ali and Jaafar Khalaf Ali

Background: Hypothyroidism is one of the most common forms of thyroid dysfunction. It is influence on the value of electrolytes.

Objective: The study was designed to find out the effect of hypothyroidism on some electrolytes and total calcium levels.

Patients and materials: A total of thirty known cases of hypothyroidism and twenty age and sex match controls were selected. Blood samples were taken from both (patients and control) to evaluate thyroid stimulating hormone (TSH) by ELISA method, as well as potassium, sodium and calcium were measured automated by Genex Elyte 4 device.

Results: It was found the levels of total calcium and sodium were decreased significantly (p<0.05) cases as compare with control group, while the level of potassium was decreased no significantly (p>0.05) in cases than control. Also, the results were indicated to a significant negative correlation between serum TSH value and calcium level in patients. Increased the TSH levels, lower will be the levels of serum calcium, sodium and potassium levels.

Conclusion: It was concluded the level of total calcium was decreased significantly in person with hypothyroid as well as sodium.

研究論文

Treatment Outcomes and Associated Factors of Preterm Birth of Neonates Admitted in Intensive Care Unit of Dessie Referral Hospital, North Central Ethiopia

Moges Workneh Ayele, Gebire Yitayih, Solomon Emshaw, Samual Anteneh Ayele and Birhanu Demeke Workneh

Background: Globally, preterm birth and its complications have become major public health problems, which account 28% of all neonatal deaths; it is also accompanied by substantial perinatal morbidity.

Objective: To assess treatment outcomes and associated factors of preterm birth of neonates admitted in a neonatal intensive care unit of a Dessie Referral Hospital, Ethiopia.

Methods and materials: This study employed cross-sectional study design to review medical records of 290 preterm birth neonates retrospectively using simple random sampling technique during the past three years prior to this data collection period (January 2013 to January 2016) admitted in Dessie Referral Hospital. The data were collected using pre-tested and structured checklist and then entered, cleaned and analyzed by using SPSS version 20. Results were presented in the form of tables and narrations. Crude odds ratio and adjusted odds ratio analysis were performed to test the association between poor treatment outcomes of preterm birth neonates and associated factors.

Results: Overall survival proportion of neonates at hospital discharge was 62.1%, while the mortality rate was (30.9%). Gestational age (AOR=2.60; CI: 1.24-5.47), Apgar score at 5 minutes (AOR=7.54; CI: 2.150-26.44), sex (AOR=1.88; CI: 1.031- 3.42), types of feeding (AOR=7.09; CI: 3.20- 20.43) and place of delivery (AOR=2.47; CI: 1.33 -4.58) were factors associated with poor treatment outcomes of preterm birth neonates. The commonest medical conditions were hypothermia in 129 (44.5%) followed by respiratory problems in 108 (37.2%) and jaundice in 57 (19.6%) of the patients.

Conclusion: Gestational age, APGAR score at 5 minutes, sex, and place of delivery were among the factors associated with poor treatment outcomes of preterm birth neonates admitted in neonatal intensive care unit of Dessie Referral Hospital. The mortality rate of preterm neonates observed in this study was high which indicates that the survival of preterm neonates must be improved.

研究論文

To Be Safe at Home or at Hospital After Autologous Stem Cell Transplantation - Why Readmission to Hospital

Anncarin Svanberg

Background: Chemotherapy in connecting with autologous stem cell transplantation (SCT) is an established treatment for patients diagnosed with myeloma and lymphoma. Chemotherapy has side effects nausea/vomiting, infection, diarrhoea, fatigue and oral mucositis. SCT often requires hospitalization for weeks. Today it is common to treat patients in an outpatient care in combination with visits at the clinic/ward. Despite experience about outpatient care in connection with SCT, it is still a small proportion of patients who are treated on an outpatient basis. Reasons to readmit unplanned from homecare to hospital are mainly incidence of infection.

Purpose: To investigate in what extend patients undergoing autologous SCT, received an outpatient care or care at a University hospital in Sweden during transplant period and if the treatment at outpatient care was interrupted to study the reason for readmitting to hospital care, also to compare intra venous (iv) treatment with antibiotics or total parenteral nutrition and length of hospital stay.

Methods: The study was a quantitative, retrospective, descriptive design. A review from medical and nursing records of 88 adult patients who underwent autologous SCT in 2013-2014 and treated at a University Hospital in Sweden.

Results: Thirty-nine patients were cared for outside hospital at home/home-like environment and 28 of them were readmitted to hospital. Forty-nine was cared for at hospital ward. The results showed that the main reason of readmission to hospital was related to nausea/vomiting, oral mucositis, stomach problem or other reason. No patients treated outside the hospital in the home/home-like environment the entire post-transplant period (n=11) needed total parenteral nutrition in contrast to patients readmitted to hospital (n=28) where 7 patients needed total parenteral nutrition. Among patients cared for at hospital ward during the entire post- transplant period (n=49), 17 patients needed total parenteral nutrition.

Conclusion: Staying at home during the transplant period leads to less total parenteral nutrition, iv antibiotics and fewer days in the hospital.

研究論文

Revealing the Conceptual Definition of Frailty: A Qualitative Study

Yuxiao Xia, Ying Zhou, Hongjing Yu, Yun Gao, Joanne WY Chung and Thomas KS Wong

Aim: The aim of this study was to uncover the conceptual definition of frailty from content experts.

Methods and participants: This was a qualitative study with in-depth interviews. Informants were recruited by purposive sampling. Twenty-seven informants who had rich experience with elderly care were interviewed.

Results: Three domains emerged as the conceptual definition of frailty. The three domains were physical, mental, and social. With the decline in bodily function, some elderly’s daily needs have to be partially taken care of, or they may be substantially or even completely dependent. The physical domain was further divided into lung deficiency, blood deficiency, kidney deficiency, spleen deficiency, sarcopenia, osteoporosis, and joint pain. This was a reflection of elements in traditional Chinese medicine. The mental domain included emotion and mood. The social domain included both social support and social activities.

Conclusion: There were three domains in the conceptual definition of frailty, namely, physical, mental, and social. Cultural elements were reflected in the physical domain through the traditional Chinese medicine.

研究論文

Assessment of Anxiety and Depression among Heart Failure Patients at King Faisal Cardiac Center, King Khalid Hospital, Jeddah

Amal I Khalil and Meead F Muneer

Background: Cardiovascular diseases are extremely common in Saudi Arabia. Depression and anxiety is highly prevalent in patients with heart failure disease and heralds adverse cardiovascular outcomes and increased health care costs. The aim is to assess the occurrence and severity level of anxiety and depression among heart failure patients.

Methods: A Cross sectional correlational survey design was used to recruit 60 heart failure patients from King Faiesal cardiac center at King Khalid hospital Jeddah. The Arabic version of Beck Anxiety Inventory (BAI) and Zung self-rating depression scale were adopted and used to collect data. The results revealed that only (15%) of the study population have mild degree of depression while the majority 78.9% have moderate level of anxiety compared by 10.0% have severe level of anxiety. The study results showed a 23.52% of severe anxiety among patients who were diagnosed with heart failure 6-20 years ago and female, who had higher educational level and history of heart failure are at risk for depression and anxiety more than male patients.

Conclusion: Anxiety and depression comorbid with heart failure patients with different degree starting from mild to severe level of anxiety and only mild level of depression was reported among study population. Female gender, duration of illness and pervious history of heart failure and psychiatric illness have an association with the severity of depression and anxiety with apparent significant difference among study population. Therefore, awareness training program targeting patients to help them detect depression and anxiety manifestations that may affect them either because of their long life chronic disease or dependency feeling on their families. Moreover, providing heart failure patients with psychosocial and Liaison psychiatric services to support patients’ mental health problems through referral or follow up.

研究論文

Role of Nurses in Nutrition Care in Hospitals in Srinagar City (Jammu and Kashmir, India)

Nayera Masoodi, Veenu Seth and Kalyani Singh

The nurse is the hub of all activities in a hospital, centered on the patient, who makes the patient get more individualised care. The present study was carried out in hospitals of Srinagar city (Jammu and Kashmir) to know the role of nurses in nutrition care of patients. A total of 11 hospitals registered under the Directorate of health services (Srinagar) capital of Jammu and Kashmir, India were included in the study. Hospitals were coded as (H1- H11) in order to maintain confidentiality. Data was collected using interview schedule through observation and discussion as well. The sample consisted of 62 nurses, representing 2% from each hospital. It involved gathering of both qualitative and quantitative data. A scoring pattern was formed to evaluate the nutrition care of patients by nurses. Senior staff nurses were interviewed taken from each hospital. Recommendations were developed after the conclusion was derived from the study. Results revealed that it was seen that most of the hospitals, nurses assisted patients only when the patient asked for help at meal time. Patients were not monitored by nurses at meal times and they were looked after by their own attendants. The nurses did not feel that it was their responsibility to ensure or oversee meal service. They responded that this was the job of stewards or delivery boys. It appeared that assisting patients for meals was not considered a major responsibility of nurses and this task was mostly left to the patients’ attendants. Only at H7, nurses performed their role in nutrition care. At most of the hospitals, patients’ food intake was overseen by their attendants as indicated by 97% nurses. The scoring pattern revealed that out of 11 hospitals, nurses at H7 were performing most jobs for patient’s nutrition care and thus received a score of 2. In all other hospitals, a score of 0 was received as nurses were found to be involved only to a minimal extent, if at all, with nutrition care of patients, indicating that their involvement needs to be increased to improve the quality of care. It involved gathering of both qualitative and quantitative data. A scoring pattern was formed to evaluate the nutrition care of patients by nurses. Senior staff nurses were interviewed taken from each hospital. Recommendations were developed after the conclusion was derived from the study. They were however convinced of the need for implementing the recommendation and expressed that they would attempt to bring out the changes such as having a dietetic department and dieticians in hospitals.

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