Excellence in Research and Innovation for Humanity

International Science Index

Commenced in January 1999 Frequency: Monthly Edition: International Abstract Count: 48522

Nursing and Health Sciences

287
83763
Association of Family and Friend Support for Eating Habits and Exercise with Self-Leadership in Surgically Treated Colorectal Cancer Patients
Abstract:
Objectives: Self-leadership that is defined as a process of influencing oneself was established as an enhancement of self-management concepts. The purpose of this study was to examine the association of family and friends’ support for eating habits and exercise with self-leadership. Important factors such as age, marital status, employment status, income, having a religion, residence, and the number of family members was controlled to investigate the association between family’s and friend’s support and self-leadership. Methods: For this cross-sectional study, consecutive 253 patients who had undergone primary curative surgery for colorectal cancer participated in the study from National University hospitals form two regions in South Korea, between November 2015 and March 2016. Patients with colorectal cancer were eligible to participate if they (a) were over 19 years or older, (b) had a past diagnosis of colorectal cancer (stage I, II, or III) within 2 years, (c) were ongoing or completed cancer therapy, (iii) had no other history of cancer. The questionnaire was designed to gather demographic information (age, sex, education level, marital status, monthly household income, employment status at diagnosis, whether or not they had a religious affiliation, residence, number of family members), social support for eating habits and exercise, and self-leadership. Results: A higher perception of social support for eating habits was correlated with the following subscale of the self-leadership: family’s encouragement with higher behavior awareness and volition in self-leadership adjusted. A higher perception of social support for exercise was correlated with the following subscales of the self-leadership: family’s participation and involvement with higher behavior awareness and volition, task motivation, and cognitive construction in self-leadership; friend’s exercising together with higher behavior awareness and volition, and task motivation; family’s rewards and punishment with higher behavior awareness and volition, and task motivation. Conclusion: This study demonstrates that for eating habits of patients with colorectal cancer, family’s encouragement was associated with self-leadership. For practicing exercise, family’s participation, and rewards and punishment, and friend’s exercising together was correlated with self-leadership, and family’s participation was additionally correlated with the cognitive construction. The partnership between laypersons including family members and friends could be utilized for community-based participatory cancer care for long-term, cost-effective and comprehensive cancer care.
Digital Article Identifier (DAI):
286
83276
Jordanian Health Care Providers' Attitudes toward Overweigth and Obese Women during Childbirth
Authors:
Abstract:
Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.
Digital Article Identifier (DAI):
285
83245
Students and Teachers Perceptions about Interactive Learning in Teaching Health Promotion Course: Implication for Nursing Education and Practice
Abstract:
Background: To our knowledge, there is lack of studies that describe the experience of studying health promotion courses using an interactive approach, and compare students’ and teachers perceptions about this method of teaching. The purpose of this study is to provide a comparison between student and teacher experiences and perspectives in learning health promotion course using interactive learning. Design: A descriptive qualitative design was used to provide an in-depth description and understanding of students’ and teachers experiences and perceptions of learning health promotion courses using an interactive learning. Study Participants: About 14 fourteen students (seven male, seven female) and eight teachers at governmental university in northern Jordan participated in this study. Data Analysis: Conventional content analysis approach was used for participants’ scripts to gain an in-depth description for both students' and teacher’s experiences. Results: The main themes emerged from the data analysis describing the students’ and teachers perceptions of the interactive health promotion class: teachers’ and students positive experience in adopting interactive learning, advantages and benefits of interactive teaching, barriers to interactive teaching, and suggestions for improvement. Conclusion: Both teachers and students reflected positive attitudes toward interactive learning. Interactive learning helped to engage in learning process physically and cognitively. Interactive learning enhanced learning process, promote student attention, enhanced final performance, and satisfied teachers and students accordingly. Interactive learning approach should be adopted in teaching graduate and undergraduate courses using updated and contemporary strategies. Nursing scholars and educators should be motivated to integrate interactive learning in teaching different nursing courses.
Digital Article Identifier (DAI):
284
83216
Pregnancy Outcomes among Syrian Refugee and Jordanian Women: A Comparative Study
Abstract:
Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.
Digital Article Identifier (DAI):
283
83002
Assessing the Impact of High Fidelity Human Patient Simulation to Foster Teamwork in Nursing, Medicine and Pharmacy Undergraduate Students
Abstract:
High fidelity human patient simulation has been used for many years by medicine, nursing and pharmacy programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork in nursing, medicine and pharmacy undergraduate students. This study used a within group, pretest, posttest, repeated measures (crossover) design to compare the impact of student participation in high fidelity versus low fidelity simulation based on the care of a deteriorating patient experiencing acute anaphylaxis. Changes in students’ knowledge of teamwork, attitudes towards interprofessional education, and teamwork communication and collaboration behaviors were assessed. This presentation will focus on preliminary findings related to changes in student’s knowledge of teamwork and attitudes towards interprofessional education. The challenges of designing, implementing and evaluating high fidelity human patient simulation teaching and learning experiences for nursing, medicine and pharmacy undergraduate students will also be discussed.
Digital Article Identifier (DAI):
282
82968
Big Data for Local Decision-Making: Indicators Identified at International Conference on Urban Health 2017
Abstract:
The Sustainable Development Goals (SDGs) and Urban Health Equity Assessment and Response Tool (Urban HEART) identify dozens of key indicators to help local decision-makers prioritize and track inequalities in health outcomes. However, presentations and discussions at the International Conference on Urban Health (ICUH) 2017 suggested that additional indicators are needed to make decisions and policies. A local decision-maker may realize that malaria or road accidents are a top priority. However, s/he needs additional health determinant indicators, for example about standing water or traffic, to address the priority and reduce inequalities. Health determinants reflect the physical and social environments that influence health outcomes often at community- and societal-levels and include such indicators as access to quality health facilities, access to safe parks, traffic density, location of slum areas, air pollution, social exclusion, and social networks. Indicator identification and disaggregation are necessarily constrained by available datasets – typically collected about households and individuals in surveys, censuses, and administrative records. Continued advancements in earth observation, data storage, computing and mobile technologies mean that new sources of health determinants indicators derived from 'big data' are becoming available at fine geographic scale. Big data includes high-resolution satellite imagery and aggregated, anonymized mobile phone data. While big data are themselves not representative of the population (e.g., satellite images depict the physical environment), they can provide information about population density, wealth, mobility, and social environments with tremendous detail and accuracy when combined with population-representative survey, census, administrative and health system data. The aim of this paper is to (1) flag to data scientists important indicators needed by health decision-makers at the city and sub-city scale - ideally free and publicly available, and (2) summarize for local decision-makers new datasets that can be generated from big data, with layperson descriptions of difficulties in generating them. We include SDGs and Urban HEART indicators, as well as indicators mentioned by decision-makers attending ICUH 2017.
Digital Article Identifier (DAI):
281
82892
Influence of Causal beliefs on self-management in Korean patients with hypertension
Authors:
Abstract:
Patients’ views about the cause of hypertension may influence their present and proactive behaviors to regulate high blood pressure. This study aimed to examine the internal structure underlying the causal beliefs about hypertension and the influence of causal beliefs on self-care intention and medical compliance in Korean patients with hypertension. The causal beliefs of 145 patients (M age = 57.7) were assessed using the Illness Perception Questionnaire-Revised. An exploratory factor analysis was used to identify the factor structure of the causal beliefs, and the factors’ influence on self-care intention and medication compliance was analyzed using multiple and logistic regression analyses. The four-factor structure including psychological, fate-related, risk and habitual factors was identified and the psychological factor was the most representative component of causal beliefs. The risk and fate-related factors were significant factors affecting lower intention to engage in self-care and poor compliance with medication regimens, respectively. The findings support the critical role of causal beliefs about hypertension in driving patients’ current and future self-care behaviors. This study highlights the importance of educational interventions corresponding to patients’ awareness of hypertension for improving their adherence to a healthy lifestyle and medication regimens.
Digital Article Identifier (DAI):
280
82884
Mobile Asthma Action Plan for Adolescent with Asthma: A Systematic Review
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Abstract:
Asthma is the common health problems in adolescents. Self-management is one way to improve health status in adolescent with asthma. Mobile technology has the potential to improve self-management in adolescents with asthma. Objective: the aim of this study to determine the effectiveness of using the mobile technology Asthma Action Plan to improve self management. Method: this study is Systematic review approach using PRISM template. The literature search started on first September 2017 by using electronic data Pro Quest and Google Scholars with keywords ‘Mobile AAP’ and ‘Adolescent Asthma’. Results and Conclusion: M-AAP is effective to improve adolescent self-management with asthma because it is easy to use and provide information appropriately. The improvement of self-management in teenagers will enhance the quality of life of adolescents with asthma. The recommendation of this study is the addition of parental control content in the application appropriate with Family Centered Care (FCC) philosophy on pediatric nursing. In addition, it is expected the development of applications for other chronic diseases such as diabetes mellitus and congestive heart failure.
Digital Article Identifier (DAI):
279
82844
Health Portals for Specific Populations: A Design for Pregnant Women
Abstract:
The technologies and communication advances contributed to new tools development which allows patients to have an active role in their own health. In the light of information needs and paradigms changes about health, the patient self-manages their care. This line of care focuses on patients; specific portals come up to people with particular requirements like pregnant women. Thinking of a portal design to this sector of the population, in September 2016 a survey was made to users with the objective to knowing and understanding information’s needs at the moment to use an application for pregnant. Also, prototypes of the portal´s features were designed to try and validate with users, using the methodology of human-centered design. Investigations have made possible the identification of needs of this population and develop a tool who try to satisfy, providing timely information for each part of pregnancy and allowing the patients to make a physical check and the follow up of pregnancy seeking advice from our obstetricians.
Digital Article Identifier (DAI):
278
82806
Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice
Abstract:
Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.
Digital Article Identifier (DAI):
277
82796
Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study
Abstract:
Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.
Digital Article Identifier (DAI):
276
82786
The Use of Stroke Journey Map in Improving Patients' Perceived Knowledge in Acute Stroke Unit
Abstract:
Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.
Digital Article Identifier (DAI):
275
82523
Heat Effects of Ambient Apparent Temperature on Cardiovascular Disease Mortality in Cape Town and Johannesburg, South Africa: 2006-2010
Abstract:
Introduction: Although many studies of temperature have been conducted in other disciplines such as climatology, they have only received greater attention in public health and epidemiology in the past decade. However, very few studies have been conducted in Africa and none which also controlled for possible confounding by air pollution. Methods: The objective of this study was to investigate the influence of heat effects of ambient apparent temperature (Tapp) on cardiovascular disease (CVD) mortality in Cape Town and Johannesburg. The cities are located in different Köppen-Geiger climatic zones, namely a Mediterranean climate (Csb) and subtropical highland climate (Cwb), respectively. The time-series and case-crossover epidemiological study designs were applied. Tapp had a linear association with CVD mortality in both cities. The heat effect was investigated for Tapp above the daily minimum in Cape Town and Johannesburg, namely 8°C and 0°C, respectively. The average Tapp on the day before (lag1) and on the day of death (lag0) was used in the models (lag0-1). Models were adjusted for air pollution, namely PM10 (lag0-1). Susceptibility by age was explored for =60 year olds. Blind version Results: No heat waves occurred in the two cities. The daily average Tapp was 16.6°C and 15.0°C in Cape Town and Johannesburg, respectively. The daily average PM10 level was 7.9 and 7.7 µg/m3 , respectively. PM10 levels exceeded the WHO daily guideline (50 µg/m3 ) on 200 and 807 days, respectively. The daily number of CVD deaths was on average 10.3 and 9.9, respectively. In Cape Town, CVD mortality decreased by 7.6% and 1.7% for =60 year olds, respectively per IQR increase in Tapp (7°C). In Johannesburg, CVD mortality decreased by 8.1% and 4.7% for =60 year olds, respectively per IQR increase in Tapp (7°C). Conclusion: These results are in agreement with some studies that reported protective effects on CVD mortality with increasing ambient temperature under non-heat wave conditions. The study will be expanded to include five other South African cities located in different Köppen-Geiger climatic zones.
Digital Article Identifier (DAI):
274
82493
Learning-Teaching Experience about the Design of Care Applications for Nursing Professionals
Abstract:
Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.
Digital Article Identifier (DAI):
273
82491
Development of Technologies for the Treatment of Nutritional Problems in Primary Care
Abstract:
Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.
Digital Article Identifier (DAI):
272
82489
Technology in the Calculation of People Health Level: Design of a New Computational Tool
Abstract:
Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.
Digital Article Identifier (DAI):
271
82431
Factors Associated with Wheeze and Dry Cough in Young Children Living in an Industrial Area of Gauteng Province, South Africa
Abstract:
Objective: To determine risk factors associated with mother-reported wheeze and dry cough in children (1 to 26 months old) living in Tembisa, South Africa. Methods: A cross-sectional epidemiology study was conducted during February and December 2016. The International Study of Asthma and Allergies in Childhood questionnaire was used, with additional questions concerning tobacco use, income, living conditions and educational status of the mothers. Data analysis included chi-square tests and logistic regression models. Results: Mothers of nearly 500 (n=493) children took part in the study. The prevalence of wheeze ever and dry cough ever was 16.4% (n=81) and 37.7% (n=186), respectively. The mothers lived in the study area on average for 25.2 years (SD 9.7 years). After controlling for confounders, a significant association was observed between wheeze ever and the number of years the mothers had lived in the study area (OR 1.05; 95% CI: 1.01-1.08). Children who had trucks passing on their home streets frequently everyday were nearly four times more likely to have ever had dry cough compared to those with no truck passing on their home street (OR 3.88: 95% CI: 2.29-6.57). Conclusion: This study observed a strong association between frequency of trucks passing in front of children’s homes and dry cough in very young children. Furthermore, the longer a mother lived in the industrial community, the more likely her child was to have ever wheezed.
Digital Article Identifier (DAI):
270
82362
The Spiritual Distress of Women Coping with the End of Life and Death of Their Spouses
Authors:
Abstract:
Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.
Digital Article Identifier (DAI):
269
82307
Factors Affecting Hypertension Free Survival in India: Findings from Recent Cross-Sectional Survey
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Objectives: Being the most important modifiable risk factor for cardiovascular diseases, study of hypertension free survival becomes immensely important. Moreover, hypertension is majorly contributed by lifestyle factors, and thus it becomes vital to compare the hypertension free survival of respondents with the factor which affect the lifestyle of respondent. The present study explores hypertension free survival patterns of adult respondents with respect to various socio-economic and demographic factors in eighteen demographically developed states of India. Material and Methods: The study utilizes data from the fourth round of District Level Household Survey (DLHS) undertaken during 2012-2013. The study computes the survival functions by five year age group followed by Peto and Pike’s test for assessing the significant differences in the survival pattern between the various sub-groups in eighteen states of India with better demographic indicators. Results: The study points out that the hypertension free survival of a respondent is affected by factors like place of residence, sex, social group, Standard of living (Wealth Index) and region of residence. Conclusion: Prevalence of hypertension can be reduced by bringing about changes in the lifestyle factors. These lifestyle factors are highly contributed by urbanization. Increasing the level of physical activity, avoiding excess fat intake, avoiding use of alcohol and tobacco can be some preventive measures in order to reduce hypertension prevalence. Further, use of social marketing needs to done in order to enhance preventive health care in hypertension.
Digital Article Identifier (DAI):
268
82305
Variation of Diabetes Free Life in India: Application of Survival Function Analysis
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Abstract:
Background: India is considered to be a diverse nation which includes population from various socio-economic and demographic backgrounds. These factors often influence the lifestyle pattern which further affects the diabetes-free survival in the population. The present study explores diabetes-free survival patterns of adult respondents with respect to various socio-economic and demographic factors in eighteen states of India with better demographic indicators. Material and Methods: The study utilizes data from the fourth round of District Level Household Survey (DLHS) undertaken during 2012-2013. The study computes the survival functions by five year age group followed by Peto and Pike’s test for assessing the significant differences in the survival pattern between the various sub-groups in eighteen states of India with better demographic indicators. Results: The study points out that the diabetes-free survival of a respondent is affected by factors like place of residence, sex, social group, standard of living (Wealth Index) and region of residence. Conclusion: Owing to rapid urbanization, the diabetes-free survivor is particularly reduced in population groups which are experiencing the resultant changes in lifestyle in terms of unhealthy dietary pattern and physical inactivity. Timely detection, screening and treatment of Non-communicable diseases as well as palliative care are recommended to the community for diabetes prevention. A healthy lifestyle including healthy diet, physical activity on regular basis and avoiding tobacco needs to be promoted.
Digital Article Identifier (DAI):
267
82297
Factors Affecting Heterogeneity between Self-Reported and Measured Data on Diabetes in India
Authors:
Abstract:
Background: Estimates obtained from self-reported data are often less reliable. Thus, there are often some heterogeneity existing in between the self-reported and measured estimates of disease prevalence. This study assessed the determinants of heterogeneous reporting in self-reported and standard measures of diabetes. Materials and Methods: The study utilizes data from the fourth round of District Level Household and Facility Survey, (DLHS-4), 2012-13 and considered 860501 nationally representative adult sample from eighteen states of India. Sensitivity and specificity followed by the multinomial logit regression model are used to draw inferences from the data. Results: Findings show heterogeneity by comparing respondents’ Clinical Anthropometric and Biochemical (CAB) test results with their self-report data. Further respondent’s age, sex, wealth, and occupation are the major determinants of heterogeneous in reporting. Conclusion: The study suggests that large-scale surveys should employ using standard measurement tools along with self-reported data for data collection. Also, self-reported data, if employed, should be interpreted with caution.
Digital Article Identifier (DAI):
266
82095
The Discussion of Peritoneal Dialysis Patients Taking Proper Portion of Valacyclovir
Abstract:
Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.
Digital Article Identifier (DAI):
265
81992
A Spatial Analysis of Pattern and Determinants of Cardiovascular Disease Burden among Indian Agro-Climatic Regions during 2004-2014
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Abstract:
Due to the epidemiological transition, the morbidity burden of non-communicable diseases (NCDs) is escalating like an ‘epidemic’ in India. However, like the other NCDs, the consequences of cardiovascular diseases (CVDs) are significantly catastrophic. Attributable to lack of research in this area, the study recognizes the lacuna in assessment and exploration of the pattern of CVD burden and its determinants at the regional level in India during 2004-2014 using National Sample Survey (NSS) 60th (2004) and 71st (2014) round survey data. Univariate and bivariate local Moran’s I and Local Indicator of Spatial Association (LISA) maps and spatially autoregressive models (SARMs) were generated to achieve the overall study objective. The proportion of rich, elderly (sixty and above) population, urbanized areas, and divorced-widowed-separated population have a positive impact on the burden of CVDs at the regional level, but the proportion of employment and literacy are playing a protecting role to reduce the burden across both spatial and spatiotemporal settings. The findings establish the fact that prevalence of CVDs is significantly and rapidly escalating like an ‘epidemic’ and a high-level regional disparity on CVD burden is evident after a decadal change also. Thus an urgent need to strengthen the existing policies and programs which are pertinent to non-communicable diseases (NCDs) especially for CVDs not only just at national level but also at the regional level to reduce the spatial heterogeneities. Additionally, special attention on the geriatric population suffering from CVDs is highly needed.
Digital Article Identifier (DAI):
264
81637
Regional Analysis of Non-Communicable Disease Burden in India
Authors:
Abstract:
The epidemiological transition has resulted in elevating the burden of morbidity from non-communicable diseases (NCDs) in India. Because of the lacking of research to provide small area estimates for India, present study unfolds small area estimates of the NCD burden in India using data from National Sample Survey (NSS) 60th (2004) & 71st (2014) round. A series of quantile maps, local Moran's I, LISA cluster & significance map have been generated to achieve the overall study objective. Moran’s I scatterplot depicts that a high level of regional dependence (Moran’s I=0.558) of NCDs is present and it is highly significant (based on the simulated P-Value=0.001). All the hotspots are located in southern states like Kerala (Northern & Southern), Tamil Nadu (Inland, Coastal, and Northern Coastal), Karnataka (Inland, Coastal & Ghats) & Pondicherry only. The proportion of the elderly (60 & above) population, urbanized areas, widowed-divorced-separated population, per capita alcohol & tobacco consumption are playing a major role to increase NCD burden. The study shows that the country representative household data on consumption expenditure and social consumption: health can profitably be allied to examine the spatial pattern of NCD burden at the regional level. The strong spatial clustering & heterogeneity of NCD burden are present across agro-climatic regions in India and gradually its spatial progression was seen from high to low-level. An immediate attention is required to the identified hotspots & other regions which are at higher quantile of NCD burden and some cost-effective schemes with better built-in mechanisms. The estimates computed from the study would serve as an input for government and policymakers to closely monitor the existing policies & programs at the small area level. Immediate attention is required to reduce geographic heterogeneity of NCDs by the effective implementation of cost-effective measures. The present study also recommends to strengthen existing policies and implement some new cost-effective programs with a special focus on the geriatric population in order to combat with these prolonged chronic diseases.
Digital Article Identifier (DAI):
263
81279
The Effect of a Computer-Assisted Glycemic Surveillance Protocol on Nursing Workload
Abstract:
The aim of this study was to determine the effect of a computer-assisted glycemic surveillance protocol on nursing workload in intensive care unit. The study is completed in an Education and Research Hospital in Ankara with the attendance of volunteered 19 nurse who had been worked in reanimation unit. Nurses used the written protocol and computer-assisted glycemic surveillance protocol for glycemic follow-up approach of the intensive care patients. Nurses used the written protocol first in the glycemic follow-up of the patient, then used the computer-assisted protocol. (Nurses used the written protocol first, then the computer-assisted protocol in the glycemic follow-up of the patient). Less time was spent in glycemic control with computerized protocol than written protocol and this difference is statistically significant (p < 0.001). It was determined that the computerized protocol application was completed in about 10 seconds (25% shorter) than the written protocol implementation. The computer-assisted glycemic surveillance protocol was found to be more easy and appropriate by nurses and the satisfaction level of the users was higher than with written protocol. While 79% of the nurses find it confusing to implement the written protocol, 79% were satisfied with the use of computerized protocol.
Digital Article Identifier (DAI):
262
81206
The Survey of Relationship between Health Literacy and Knowledge of Heart Failure with Rehospitalization in Patients with Heart Failure Admitted to Heart Failure Clinic
Abstract:
Introduction: Despite the progress in new effective drugs in the treatment of heart failure, the disease still accompanied with frequent hospitalization, impaired quality of life, early mortality and significant economic burden. Patients with chronic disease and consequently patients with heart failure need the knowledge and optimal health literacy to improve the quality of life and minimize the rate of rehopitalizatio. So, considering to importance of knowledge and health literacy in this patients as well as contradictory literature, this study conducted to investigate the relationship between health literacy and Knowledge of heart failure with rehospitalization in patients with heart failure admitted to heart failure clinic in Rajai Heart center in 1394. Methods: The cross-sectional method with convenience sampling method was used in this study. After obtaining the necessary permissions from the ethics committee and the Shahid Rajai Heart center, 238 patients who were older than 18 years and had ejection fraction 35% or less with the ability to read and write and lack of psychiatric, neurological and cognitive disorders and signed the informed consent were recruited. Data collection were perfomed through demographic data questionnaire, short standard health literacy questionnaire 'Short-TOFHLA-16' and Vanderwall (2005) knowledge of heart failure questionnaire. Reliability was assessed by internal consistency method and Cronbach's alpha for both questionnaires was more than 0.7. Then data were analysed by SPSS-20 with descriptive statistic and analytical statistic such as T-test, Chi-square and ANOVA. Results: The majority of patients were male (66%), married (80%) and had age between 50 to 70 years old (42%). The majority of studied men and women have good health literacy and About half of them have adequate knowledge about heart failure. Fisher's exact test showed that there was a significant statistical correlation between health literacy and knowlegh about heart failure. In other words, higher health literacy associated with more knowledge about their condition. Also findings showed that there was no significant statistical correlation between health literacy and knowledge about heart failure and frequency of CCU and emergency admissions. Conclusion: The study results showed that the higher health literacy, associated with the greater knowledge about heart failure and patients' perception about caring recommendations and disease outcomes. Therefore, the knowledge about heart failure and factors which related to severity of the disease, is the important issue to problem identification and treatment and reduction of rehospitalization.
Digital Article Identifier (DAI):
261
81045
Using Longitudinal Data for Spatial Analysis: Case Study of Urban-Rural Health Inequalities in Southern Spain
Abstract:
Background: The analysis of urban-rural health inequalities has been commonly approached using quantitative data derived from traditional sources such as aggregated data based on vital statistics or surveys. Most of the analysis involving individual level data have either made use of cohorts' follow-up and small-scale studies or focused on small areas and specific cities. Regrettably, relevant research exploring large-scale demographic, epidemiologic and socio-economic individual level data, simultaneously accounting for environmental determinants and using advanced techniques to explain spatial variations in health outcomes with fine resolution is rarely disseminated. We believe that both socio-economic conditions and geographic environment equally define health quality of individuals living and working in Andalusia. In this context, we conduct a comprehensive analysis of risk factors accounting for higher mortality rates in rural or urban areas. We pay specific attention to infrastructure, access to healthcare and public health services, local land use patterns and environmental exposures of various natures and involve these in the geostatistical analysis along with traditional urbanicity measures to understand how place and environment affect age specific mortality. Data and Methods: Longitudinal Statistics on Survival and Longevity in Andalusia for 2002-2017 are the fundamental data for this study. Following life trajectories of 10 million individuals during 15 years, these data provide a thorough demographic and socio-economic insight for the individual habitat. On the further steps of the analysis, these data are aggregated to the census tract level to respect the privacy policy and reassure that single individuals or households are not identifiable. To combine longitudinal statistics with the environmental characteristics, we make use of a spatial database created by authors specifically for this study and containing feature datasets corresponding to natural and anthropogenic components of the environment derived from Basic Spatial Database of Andalusia and open-source European repositories. In order to model spatial relationship between environment and mortality at the census tract level, we deploy a set of integrated R-Python models designed to perform stepwise data processing, spatial data mining and statistical modelling. Results: The outputs from the comprehensive mortality analysis based on a wide set of demographic, socio-economic and environmental variables indicate presence of statistically significant negative impact of the degree of urbanicity on the relative risk of dying after controlling for individual characteristics. Conclusion: Our findings depict individual level urban health penalty and highlight particular spatial divergences in this phenomenon across the study area. We believe that using complex integrated indicators of urbanicity at the smallest possible spatial level and combining it with a longitudinal population register is a robust, replicable and expandable approach to study demographic phenomenon in time and space within the context of progressive urban sprawl.
Digital Article Identifier (DAI):
260
81021
Health Care Providers' Perceptions on mHealth Workplace Nutrition Wellness Program: A Thematic Analysis
Abstract:
Background: Health care providers have been identified as an at-risk group for obesity. Mobile health technology can be used to motivate lifestyle behavioral changes. The aim of this study was to investigate hospital-based health care providers’ perceptions of mHealth Workplace Nutrition Wellness Program. Methods: This qualitative study was conducted at a regional hospital in Hong Kong. Ten health care providers were purposively selected for the study. Qualitative data was collected by individual face-to-face semi-structured interviews which were audio-taped, transcribed verbatim and analyzed by thematic analysis. Results: Four themes were identified: (1) mobile health technology motivates lifestyle changes, (2) self-perceived body weight initiates health behavioral changes, (3) organizational support promotes healthy behavior, (4) lack of self-confidence hinders lifestyle modification. The health care providers’ perceptions of mobile health technology, barriers, and facilitators to participation in the mHealth Workplace Nutrition Wellness Program were discussed in the study. Conclusions: Barriers, facilitators, self-perceived body weight and experiences of mobile health technology were associated with intention of participation in mHealth Workplace Nutrition Wellness Program. The knowledge generated from the study could be used to guide the design and implementation of effective interventions, strategies and policies of workplace wellness programs to promote participation for hospital’s employees.
Digital Article Identifier (DAI):
259
80931
Enquiry into Psychological and Psychosocial Aspects in Cancer Care: Cancer Diseases Hospital, Zambia
Abstract:
Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.
Digital Article Identifier (DAI):
258
80746
Prayer Therapy in a Case of Acute Myeloid Leukemia: The Good, the Bad and the Ugly
Abstract:
Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.
Digital Article Identifier (DAI):