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Full-Text Articles in Maternal, Child Health and Neonatal Nursing

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski Sep 2023

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …


Bertumbuh Berkembang: Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari Aug 2023

Bertumbuh Berkembang: Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari

Pengembangan Profesional

Pemberian Makanan Bayi dan Anak (PMBA) yang optimal akan meningkatkan kesempatan hidup dan pertumbuhan anak; juga daya tangkap untuk menguasai keterampilan serta pengetahuan yang mereka perlukan sebelum memulai pendidikan di tahun-tahun awal sekolah. Tidak hanya bagi bayi dan anak, pemenuhan gizi yang baik juga amat penting bagi ibu hamil dan menyusui. Selain penjelasan lengkap seputar PMBA dan kesehatan ibu hamil/menyusui, modul ini juga menjelaskan kepercayaan lokal yang kepercayaan lokal yang terkadang menimbulkan misinformasi dan menghambat akses bagi ibu, bayi, dan anak untuk mendapatkan nutrisi yang dibutuhkan. Modul ini akan bermanfaat bagi kader layanan kesehatan (Posyandu) untuk menyampaikan informasi yang tepat …


Bertumbuh Berkembang: Aktivitas & Lembar Evaluasi—Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari Aug 2023

Bertumbuh Berkembang: Aktivitas & Lembar Evaluasi—Modul Pemberian Makan Bayi Dan Anak (Pmba), Hikmah Kurniasari

Pengembangan Profesional

Bagian lampiran dari Modul PMBA ini berisikan ide aktivitas untuk dilakukan oleh kader Posyandu beserta orang tua/pengasuh anak, lembar evaluasi, serta refleksi modul untuk tiap-tiap bab. Lampiran ini juga dilengkapi dengan arahan untuk melakukan curah pendapat, diskusi kelompok, juga latihan kasus.


Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook May 2023

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …


Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty Dec 2022

Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective

To improve cultural competency levels of registered nurses on the Mother/Baby unit by educating nurses.

Background

Demographics are shifting in the U.S. with an increase in minority populations. Research has revealed insufficient education or a complete absence of education, resulting in nurses that are not equipped to adequately care for culturally diverse patients.

Methods

The Evidence-Based Practice Improvement (EBPI) Model guided the development and implementation of the project. A cultural competence education module was developed utilizing resources from the U.S. Department of Health and Human Services. Outcomes were measured using a pretest/posttest design tool, the Inventory for Assessing the …


Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert Dec 2022

Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert

Doctoral Dissertations

Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …


The Effects Of Prenatal Patient Education Regarding Epidural Anesthesia, Auburn Merritt Nov 2022

The Effects Of Prenatal Patient Education Regarding Epidural Anesthesia, Auburn Merritt

Symposium of Student Scholars

This project is important because there is a lack of education for prenatal women regarding epidural anesthesia which causes misunderstanding, confusion, a deficit of knowledge, and a lack of support. The purpose of this project is to analyze and suggest the importance of proper education regarding epidural anesthesia. Proper prenatal education causes resolution of misconceptions as well as causes patients to be more satisfied with their pain management during labor. Evidence that I found suggested that after proper education more pregnant women planned to receive epidural anesthesia (Cutajar, 2018). Women preferred detailed education to increase knowledge of the risks and …


Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett Apr 2022

Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett

Honors College Theses

Studies have shown that nursing students experience a greater-than-normal amount of anxiety and decreased clinical confidence when in settings involving infants and children, which is said to have a negative impact on the learning experience (Lassche, 2013; Moscaritolo, 2009). Patient education is a vital aspect of nursing, but one that the student nurse may not feel comfortable taking part in, either because of their lack of nursing experience or because of a lack of experience with infants and infant safety (Potter, 2020; Lassche, 2013). This project attempts to assess for a change in clinical confidence after providing a subject specific …


Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber Jan 2022

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …


The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook Oct 2021

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …


Using Quality Improvement (Qi)-Focused Evaluation To Redesign Direct Home- And Community-Based Services During The Covid-19 Public Health Emergency:, Marcia Moriarta, Anthony Cahill, Heidi Fredine Mar 2021

Using Quality Improvement (Qi)-Focused Evaluation To Redesign Direct Home- And Community-Based Services During The Covid-19 Public Health Emergency:, Marcia Moriarta, Anthony Cahill, Heidi Fredine

Developmental Disabilities Network Journal

Like many UCEDDs in the Developmental Disabilities (DD) network, the Center for Development and Disability at the University of New Mexico offers direct service programs in home and community settings. Before the start of the COVID-19 pandemic, services were delivered in-person to about 1,000 families across the state including clients with intellectual or developmental disabilities and/or from at-risk communities. In March 2020, due to the spread of COVID-19, a public health emergency was declared in New Mexico and home and community services were stopped throughout the state. This meant direct service programs at the Center had to turn to telehealth …


From Prenatal Through Childhood: What Infant Wellness Is All About At Nationwide Children’S Hospital, Sarah Gilbert May 2020

From Prenatal Through Childhood: What Infant Wellness Is All About At Nationwide Children’S Hospital, Sarah Gilbert

Masters Theses/Capstone Projects

This study aims to measure perceptions of family centered care among expectant mothers in Columbus while assessing potential racial differences in order to improve prenatal outcomes. In order to do this, surveys were distributed to pregnant women at 10 clinics providing prenatal care in Columbus and sleep sacks were provided to women who completed the survey. There was a total of 401 surveys collected between August 2019 and January 2020. The conclusion being that one in five women report not receiving family centered care during their prenatal appointments, however there was no racial difference for family centered care.


High-Fidelity Simulation And Clinical Judgment Of Nursing Students In A Maternal-Newborn Course, Carol Reid, Jody L. Ralph, Maher El-Masri, Katrice Ziefle Feb 2020

High-Fidelity Simulation And Clinical Judgment Of Nursing Students In A Maternal-Newborn Course, Carol Reid, Jody L. Ralph, Maher El-Masri, Katrice Ziefle

Nursing Faculty Scholarship

Clinical judgment, one’s ability to think like a nurse, is an essential skill for safe nursing practice. With the rise of simulation to replace clinical experiences, there is limited evidence regarding the effectiveness of simulation on the development of clinical judgment. This study explored differences in clinical judgment in maternal–newborn courses between undergraduate nursing students participating exclusively in simulation and those participating in hospital-based clinical experiences. Following completion of the clinical rotation, students participated in an evaluative maternal–newborn high-fidelity simulation experience that was recorded and evaluated using the Lasater’s Clinical Judgment Rubric (2007). Lasater’s Clinical Judgment Rubric scores between the …


Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings Nov 2019

Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings

Dissertations

Author: Lisa Cummings PhD RN

Fathers’ Experiences with Their Premature Infants or Unhealthy Neonates

Purpose and Background/Significance: Fifteen million babies worldwide are born prematurely each year, impacting a multitude of fathers. The importance of an early close father-infant relationship has been identified as central for the development of the child. Fathers influence on a child’s emotional and cognitive development and their physical well-being and health. Many times, the Neonatal Intensive Care Unit (NICU) is the initial contact environment between a father and his premature infant. Studies have shown that the NICU can be a stressful environment for parents, producing emotional …


The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey Dec 2017

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …


Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud. Nov 2016

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …


Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso Apr 2016

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …


A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer Jan 2016

A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer

Williams Honors College, Honors Research Projects

Due to multiple learning styles, it can be difficult to teach to large groups of students. The purpose of this study is to compare the effectiveness of two different educational interventions designed to teach infant hunger cues to undergraduate nursing students to increase the knowledge and confidence levels needed for the future teaching of infant hunger cues to new parents. Flemings VARK theory was used to guide this quasi-experimental study. A pretest posttest two-group design was used to evaluate both knowledge and confidence levels in the participants (N= 86). Data was analyzed utilizing a paired t-test. The results noted significant …


The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini Jan 2016

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …


Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn Dec 2015

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …


Educated Birth: Beliefs Vs. Outcomes, Lauren Presley Dec 2015

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”1 The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.2

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …


Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber May 2015

Family And Child Development Education For Harrisonburg Adolescents, Mollie M. Moran, Jennifer E. Corser, Julia M. Glauber

Senior Honors Projects, 2010-2019

The pregnancy rate among 15- to 17-year-old women in Harrisonburg is double Virginia's state rate (Townsend, 2008). While meeting administers and guidance counselors of Harrisonburg High School we learned that Harrisonburg High School views this issue as one that cannot be addressed by teaching abstinence in their public school. They have found that because of cultural beliefs, abstinence is not an effective tool for preventing teenage pregnancy. Instead, HHS teaches their students about safe sexual practices and how to have a healthy pregnancy in the event they were to become pregnant. The high school offers a class called “Child and …


Evaluation Of An Educational Breastfeeding Program For A Non-Profit Agency In South Texas, Marcela Urbina Zavala Jul 2014

Evaluation Of An Educational Breastfeeding Program For A Non-Profit Agency In South Texas, Marcela Urbina Zavala

Theses and Dissertations - UTB/UTPA

Breastfeeding has been recognized as the most cost effective practice to promote healthier babies among populations (Dennis, 2002). The purpose of the study was to evaluate the effect of an educational breastfeeding and a prenatal + breastfeeding program for individuals attending group classes and to compare the differences between Spanish only and English only versions of the curriculum. Two research questions were stated to know if there were significant differences between pre and post-tests scores and if there were any significant differences in the impact of the intervention between English only and Spanish only versions of the classes. The present …


Combating Autism Reauthorization Act Of 2014, Kassandra Mores Jan 2014

Combating Autism Reauthorization Act Of 2014, Kassandra Mores

Policy Analysis

On May 9, 2014, Representative Smith (R-NJ) and Representative Doyle (D-PA) introduced a bill to reauthorize the Combating Autism Act (H.R. 4631) for five years. Senator Menendez (D-NJ) and Senator Enzi (R-WY) are planning to introduce a Senate bill of the Combating Autism Reauthorization Act. The Combating Autism Act of 2011, due to sunset September 30, 2014, provides federal funding for autism research, public education, and early detection and intervention in Maine. We are hoping that you will consider voting in support of the Combating Autism Reauthorization Act.


Develop A Sudden Infant Death Syndrome (Sids) Education Package In Jordan: Using Participatory Action Research Approach To Create Ripple Of Change, Shereen Hamadneh, Jehan Hamadneh Nov 2013

Develop A Sudden Infant Death Syndrome (Sids) Education Package In Jordan: Using Participatory Action Research Approach To Create Ripple Of Change, Shereen Hamadneh, Jehan Hamadneh

eCULTURE

IInfant mortality is high in Jordan, a developing country in the Middle East, at 19 per 1000 live births. Most mortality risk factors are preventable. The SIDS incidence rate has also been extrapolated as 11.22 per 1000 live births [1]. This is much higher than the United State of America (USA), a developed country (0.54 per 1000 live births) [2]. Most of modifiable SIDS risk factors can be reduced by increasing knowledge, change behaviors and practices regarding SIDS risks and prevention measures.

There has not been a major investment in educating Jordanians about SIDS. Heath care providers are identified …


The Impact Of Simulation-Based Learning Experience On Critical Thinking Acquisition, Candice Rome Jan 2012

The Impact Of Simulation-Based Learning Experience On Critical Thinking Acquisition, Candice Rome

Nursing Theses and Capstone Projects

The purpose of this comparative experimental project was to compare the impact of simulation-based learning experiences to traditional clinical rotations on critical thinking acquisition of associate nursing students within a maternal-child course. Innovative pedagogies have been integrated in nursing programs to augment inadequate clinical placement and instructor availabilities. A longitudinal convenience sample of 45 second year associate level nursing students enrolled in a maternal-child course was utilized. Four experimental groups, 24 students were exposed to an eight-hour simulation-based learning experience in place of one clinical rotation. During the eight hour simulation day, students participated in three various maternal-child centered simulations. …


Enhancing The Cultural Competence Of Women’S Health Nurses Via Online Continuing Education, Ella T. Heitzler Aug 2011

Enhancing The Cultural Competence Of Women’S Health Nurses Via Online Continuing Education, Ella T. Heitzler

UNLV Theses, Dissertations, Professional Papers, and Capstones

By 2050, current minority groups will comprise almost half of the US population further challenging healthcare providers and nurses to deliver culturally competent care. Numerous organizations have published documents supporting cultural competence and its incorporation into nursing curricula has been encouraged since 1986. However, practicing nurses, specifically those providing care to childbearing women and families, continue to acknowledge their lack of cultural competence. This is concerning as large health disparities exist between culturally diverse women and cultural competence can lead to greater health equality and better client care. Studies have shown face-to-face education increases the cultural competence of healthcare providers; …


A Pilot Study Assessing The Value Of An “Educational Hospitalist” In An Obgyn Residency Program, Joseph E. Patruno Md, Craig Koller M.Ed, Kara Coassolo Md, Meredith L. Rochon Md, Thomas Hutchinson Md Jan 2011

A Pilot Study Assessing The Value Of An “Educational Hospitalist” In An Obgyn Residency Program, Joseph E. Patruno Md, Craig Koller M.Ed, Kara Coassolo Md, Meredith L. Rochon Md, Thomas Hutchinson Md

Department of Obstetrics & Gynecology

No abstract provided.


Using Digitized Primary Sources From The Library Of Congress's American Memory Collection To Enliven Nursing Issues And History Curriculum (Multimedia Presentation), Catherine Tymkow, Shirley Comer, Paul M. Blobaum Feb 2007

Using Digitized Primary Sources From The Library Of Congress's American Memory Collection To Enliven Nursing Issues And History Curriculum (Multimedia Presentation), Catherine Tymkow, Shirley Comer, Paul M. Blobaum

Faculty Research and Creative Activity

Background: A cohort of faculty from Governors State University were chosen to receive technology training and develop web based education projects incorporating digitized primary sources from the Library of Congress' American Memory Collection in May 2006. Using a constructivist framework, three web-enhanced projects, which are works in progress, were developed to illumine and enliven nursing's history for today's learner. These projects utilize digitized primary sources, which are defined as documents or other sources of information created at or near the time being studied. Use of primary sources is not common in nursing and represents a new approach to enhancing nursing …


The Effect Of Selected Nurse-Patient Contacts On The Attendance Of Non-Private Patients At Preparation For Childbirth Classes, Judith A. Hart Jun 1969

The Effect Of Selected Nurse-Patient Contacts On The Attendance Of Non-Private Patients At Preparation For Childbirth Classes, Judith A. Hart

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine whether selected nurse-patient contacts effected the attendance of non-private patients at Preparation for Childbirth classes. During the data collection period only six of the eight patients who met the criteria for this study were available. Each of the six patients was reached by at least one of the three types of nurse-patient contacts-- a letter of invitation to the Preparation for Childbirth classes, weekly contacts with the patients at the classes and three home visits to each patient. Tools used to collect data for this study were a personal information questionnaire, home …