Medicine and Health Sciences Commons^™

The Horns Of Dilemma: Life Or Sovereignty, Farida Bibi Mughal, Bibi Hajira Irshad Ali

School of Nursing & Midwifery

Death and dying are the bitter truth that is faced by every person inevitably. Paying respect to the decision of a patient in a hospital setting is always a challenging task. In eastern countries, family plays an important role in decision making. But it always overrides the preferences and wishes of the patient and this leads to violation of ethical principles such as autonomy, informed consent and veracity. Looking a situation from different paradigms and deciding the best solution on the ground of ethical principles should be the utmost priority of the healthcare provider.

Building A New Generation Of Midwifery Faculty Members In Bangladesh, Malin Bogren, Sathyanarayanan Doraiswamy, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

This paper presents an initiative to build a new generation of midwifery faculty in Bangladesh, with the ultimate objective of providing insight into how to build capacity in the midwifery faculty to best utilize the existing academic, health care and policy environment. The initiative focuses on a promising approach that starts with a new generation of midwifery faculty who can lead a chain of change when separating midwifery teaching from nursing. The initiative identified four different interdependent components of equal importance, namely the initiation of master’s and bachelor’s degrees, development of accreditation guidelines and tools, and a mentorship programme. Building …

Developments In Midwifery In Asia In 2017, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Implementation Of A Bachelor’S In Midwifery Programme In Pakistan: Reflections Of Midwifery Faculty, Arusa Lakhani, Sadia Abbas Ali, Kiran Mubeen, Marina Baig, Shahnaz Shahid, Rafat Jan, Karyn Kaufman

Journal of Asian Midwives (JAM)

Introduction/Objective: There is an international consensus on the significant role of competent midwives in improving maternal and newborn health indicators. Midwives and midwifery education in the developing world including Pakistan have lagged behind in being part of higher education. To enhance the quality of maternal and newborn services through competency based higher education in midwifery, the first Bachelors of Science in Midwifery (BScM) programme was introduced in Pakistan. As part of a larger study about establishing this programme, this paper focuses on the reflective logs of midwifery faculty members who initiated this new programme in Pakistan.
Method: The team of …

Exploring The Fears Of Pakistani Primi Gravidas About Childbirth, Zohra Kurji, Amina Aijaz Khowaja, Zahra Shaheen, Yasmin Mithani, Naveeda Haq

Journal of Asian Midwives (JAM)

Background: Childbirth can be a very painful experience as it brings a lot of physiological and psychological changes in women’s lives. The literature demonstrates that anxiety and fear during the birthing process is related to a woman’s ability to give birth safely; fear can lead to complications such as emergency caesarean section and a reduced ability to tolerate pain. Therefore, health care professionals need to explore fears and educate expectant mothers, most especially primi gravidas, about the birthing process.
Method: A qualitative descriptive exploratory design was used to investigate fears about childbirth. Purposive sampling was used to recruit a …

Determinants Of Quality Of Care And Access To Basic Emergency Obstetric And Neonatal Care Facilities And Midwife-Led Facilities In Low And Middle-Income Countries: A Systematic Review, Preeti K. Mahato, Edwin Van Teijlingen, Padam P. Simkhada, Catherine Angell

Journal of Asian Midwives (JAM)

Background: Maternal mortality is a major challenge to health systems in Low and Middle-Income Countries (LMICs) where almost 99% of maternal deaths occurred in 2015. Primary-care facilities providing Basic Emergency Obstetric and Neonatal Care (BEmONC) facilities, and facilities that are midwife-led are appropriate for normal birth in LMICs and have been proposed as the best approach to reduce maternal deaths. However, the poor quality of maternal services that leads to decreased utilisation of these facilities is among the major causes of maternal deaths worldwide. This systematic review studied factors affecting the quality of care in BEmONC and midwife-led facilities in …

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 …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie

School of Nursing & Midwifery

Background & Aim: Domestic violence (DV) is a global socio-cultural concern faced by a majority of women. DV has a negative impact on women’s social, physical, and psychological wellbeing. Objective was to explore perceptions regarding contributing factors to domestic violence among women.
Methods & Materials: A qualitative descriptive exploratory method was applied for the study. Purposive sampling was used to select participants through emails to respond to the web based blog created for the study. 41 worldwide participants shared their perceptions through the blogs in the study. The data were collected using a web-based discussion forum on the Urban Women …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Risk Factors Of Cardiovascular Disease And Its Recommendations In Pakistani Context., Rubina Barolia, Amber Hussain Sayani

School of Nursing & Midwifery

Cardiovascular diseases possess a major cause for fatality and disability the world over. Since last several decades, the rates of cardiovascular diseases-related deaths have decreased in a number of high-income countries but increased in low- and middle-income countries with around 80% of the burden. Despite the seriousness of cardiovascular diseases in low- and middle-income countries, minimal attention is given to the prevention of cardiovascular diseases risk factors in South Asia, particularly in Pakistan. In addition, economic and political instability is accelerating the rates of cardiovascular diseases in the country. Practical efforts are required to enhance the understanding of cardiovascular diseases …

The Feasibility Of An Internet-Based Intervention For Chinese People With Mental Illness: A Survey Of Willingness And Attitude, Xiu-Y Yao, Zheng Li, David Arthur, Lili Hu, Gen Cheng

David Arthur

Background: The easy accessibility, increasing usage, and low cost of internet make it a desirable way of providing health information and delivering interventions for health consumers. Studies in other countries have verified and confirmed the effectiveness of internet-based interventions among people with mental health problems. Similar programs have yet to commence in China. Purpose: This study investigated the willingness for, and attitude toward internet-based intervention in Chinese mental health service users and explored the feasibility of such an intervention. Methods: A cross-sectional survey utilizing a self-developed questionnaire was administered to 186 mental health service users in Beijing, between April and …

Self-Management Education Interventions For Persons With Schizophrenia: A Meta-Analysis, Haiou Zou, Zheng Li, Marie T Nolan, David Arthur, Hongxing Wang, Lili Hu

David Arthur

Although self-management education programs for persons with schizophrenia are being developed and advocated, uncertainty about their overall effectiveness remains. The purpose of this meta-analysis was to examine outcomes of self-management education interventions in persons with schizophrenia. Six electronic databases were searched. Manual searches were conducted of the reference lists of the identified studies and major psychiatric journals. Randomized controlled trials of self-management education interventions aimed at reducing relapse and hospital readmissions, as well as improving symptoms, psychosocial functioning, and adherence to medication treatment were identified. Data were extracted and the quality of included studies were rated by two authors independently. …

Nurses Attitudes Towards Perinatal Bereavement Care, Chan Moon Fai, David Arthur

David Arthur

Aim: This paper is a report of a study conducted to explore the factors associated with nurses and midwives’ attitudes towards perinatal bereavement care.Background: Caring for and supporting parents whose infant has died is extremely demanding, difficult and stressful. In some situations nurses may experience personal failure, feel helpless, and need to distance themselves from bereaved parents because they feel unable to deal with the enormity of the parental feelings of loss.Method: A correlational questionnaire study using convenience sampling was carried out in Singapore in 2007 with 185 nurses/midwives in one obstetrics and gynaecology unit.Results: Regression models showed that nurses/midwives …

Investigating Factors Associate To Nurses’ Attitudes Towards Perinatal Bereavement Care, Moon Fai Chan, Feng-Lan Lou, David Arthur, Feng-Lin Cao, Lai Har Wu, Ping Li, Miharu Sagara- Rosemeyer, Loretta Yuet Foon Chung, Li Lui

David Arthur

Aim: The purpose of this study was to explore nurses’ attitudes towards perinatal bereavement care and to identify factors associate with such attitudes. Background: Caring for and supporting parents whose infant has died is extremely demanding, difficult and stressful. It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and nurses with positive attitude to bereavement care can help bereaved parents to cope during their grieving period.
Method: Data were collected through a structured questionnaire; 334 nurses were recruited (63% response rate) from the Obstetrics and Gynaecology unit in five hospitals in …

A National Survey Of New Zealand Registered Nurses Caring Attributes, Professional Self Concept And Technological Influences, A O'Brien, David Arthur, M Woods, P Watson

David Arthur

No abstract provided.

Child Labour: A Public Health Issue, S. A. Gulzar, Samina Vertejee, Laila Pirani

Samina Vertejee

Child labour is a global practice and has many negative outcomes. According to International Labour Organization, child labour is the important source of child exploitation and child abuse in the world today. The Human Rights Commission of Pakistan has estimated the number of Pakistani working children to be around 11-12 millions, out of which, at least, half the children are under the age of ten years. It portrays the society's attitude towards child care. It is therefore, essential to break this vicious cycle and hence, enable the society to produce healthy citizens. This article analyzes the determinants of child labour …

Interaction And Cognitive Engagement In Online Discussions In Professional Development Leadership And Management Course At A Private Nursing Institution, Nimira Asif, Samina Vertejee, Sharifa Bashir Lalani

Samina Vertejee

In the Post RN BScN curriculum, one of the courses “Professional Development and Leadership (PDLM)” was offered as blended mode for the first time. In order to explore the students’ interactions and Cognitive Engagement (CE) in Online Discussion Forums (ODFs), the research team conducted a retrospective study for the first time at a private nursing institution of Karachi-Pakistan. The study was conducted by utilizing the retrospective qualitative paradigm of discourse analysis to understand student’s CE in ODFs. The study has addressed the following one main and three subsidiary research questions: How do threaded discussions (in the part of online forums) …

Women Trafficking: Causes, Concerns, Care!, Shaneela Sadaruddin Khowaja, Ambreen Tharani, Ajmal Agha, Rozina Karmaliani Professor

Ambreen Tharani

Pakistan is both a country of origin and destination as far as women trafficking is concerned. Poverty, gender discrimination, lack of education, and ignorance about legal rights are some of the underlying causes. Available data suggest several areas of concern, like, for instance: direct health effects, maladaptive coping leading to the use of illicit drugs, and inaccessibility to healthcare facilities. Therefore, numerous interventions would be required at three levels: the prevention of trafficking, the protection of victims and the prosecution of the traffickers.

Teachers’ Perceptions And Practices Of Written Feedback In Higher Education., Raisa Begum Gul, Ambreen Tharani, Arusa Lakhani, Nusrat Fatima Rizvi, Syeda K. Ali

Ambreen Tharani

This mixed-methods research aimed to understand the practices and perceptions of teachers regarding writtenfeedback. For this purpose, a survey was administered to 150 teachers forming a non-probability sample, who wereworking in various universities in Karachi. The disciplines chosen for the study included nursing, applied linguistics,medicine and education departments in institutes of higher education situated in Karachi. Before sampling, initialscreening was done to obtain a list of institutes which provide written feedback on students’ assignments. Twohomogenous groups of teachers by discipline (nursing and education) were then selected for focus group discussions.It was found that most teachers consider written feedback an important …

Factors Associated With Stress Among Adolescents In The City Of Nawabshah, Pakistan., Yasmin Parpio, Salima Farooq, Saleema Gulzar, Ambreen Tharani, Tazeen Saeed Ali, Fawad Javed

Ambreen Tharani

OBJECTIVE: To identify the risk factors of stress among school-going adolescents in rural Nawabshah, Pakistan. METHODS: The cross-sectional study was conducted in 2005, comprising 800 school-going children of 10-16 years of age in Nawabshah, through simple random sampling. Data was collected using a structured questionnaire to assess the potential risk factors of stress. A modified version of Perceived stress scale was utilized to measure stress level. SPSS 12 was used for statistical analysis, while multiple linear regression analysis was run to identify the factors associated with stress in the study population. RESULTS: Of the total, 529 (66%) children belonged to …

Community Mental Health Services: A Way Forward To Rehabilitate Chronic Mentally Ill Client., Ambreen Tharani, Salima Farooq, Anila Naveed

Ambreen Tharani

Schizophrenia and other mental illnesses produce devastating effects on a clients' personal and psychosocial wellbeing. Besides the sufferer, it has irrevocable impacts on the lives of their loved ones. With advancement in the treatment modalities, researches have proven that hospital based care and psychotropic drugs are not the sole solution in managing the client symptoms. Deinstitutionalization is the paradigm shift from hospital based to community based care model that allows client/s to spend rest of their lives in the community setting. A well-structured community care based programme that focuses on psychosocial interventions has significant contribution in treatment and rehabilitation of …

Compliance To Antipsychotic Medication: A Challenge For Client, Family And Health Care Providers., Ambreen Tharani, Salima Farooq, Faiza Saleem, Anila Naveed

Ambreen Tharani

Compliance with anti-psychotic medications plays a significant role in managing clients with schizophrenia. It not only helps in controlling the symptoms, but also decreases the risk of relapses and ultimately improves quality of life (QoL) for the clients. However, compliance with anti-psychotic medication remains a challenge for the client, family and healthcare providers. Identification of these associated factors is vital to make appropriate plan to enhance medication compliance. In this paper, various factors are highlighted that are associated with medication compliance in clients with schizophrenia.

Postpartum Depression And Childbirth Education: An Integrative Literature Review, Marialicia J. Kunkel

Grace Peterson Nursing Research Colloquium

Background: Postpartum Depression (PPD) is a mood disorder that affects approximately 15% of women. Preventative methods are key to reducing the prevalence of PPD, and childbirth educators are in a unique position to disseminate information to new parents.

Objective: The purpose of this literature to review was to investigate what PPD information is currently being incorporated in Childbirth education curriculum. The goal of this literature review was to establish whether new parents were being educated on PPD prior to giving birth and if that helped raise levels of awareness.

Methods: Articles were found using Cumulative Index of Nursing and Allied …

Validity And Reliability Testing: Urdu Translated Modified Response To Symptoms Questionnaire., Saleema A. Gulzar, Tazeen S. Ali, Khurshid Khowaja, Aamir Hameed, Debra Kay Moser Debra Kay Moser Debra Kay Moser

Tazeen Ali

OBJECTIVE:

To determine validity and reliability of the Urdu translated, modified "Response to symptoms questionnaire" (RSQ) among acute coronary syndrome (ACS) patients in Karachi.

STUDY DESIGN:

A qualitative, tool validation study.

PLACE AND DURATION OF STUDY:

Two tertiary care hospitals in Karachi, the Aga Khan University Hospital, Karachi and the Karachi Institute of Heart Diseases, from December 2010 to April 2011.

METHODOLOGY:

After making certain modifications, the original tool in English was translated into Urdu. Next, five cardiology experts evaluated the tool for its content and face validity. Test retest and inter rater reliabilities were computed for the RSQ using …

Peer Violence Perpetration And Victimization: Prevalence, Associated Factors And Pathways Among 1752 Sixth Grade Boys And Girls In Schools In Pakistan, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Hussain Maqbool Ahmed Khuwaja, Shireen Shehzad Bhamani, Tazeen Saeed Ali, Saleema A. Gulzar, Yasmeen Hassan Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Child peer violence is a global problem and seriously impacts health and education. There are few research studies available in Pakistan, or South Asia. We describe the prevalence of peer violence, associations, and pathways between socio-economic status, school performance, gender attitudes and violence at home.
Methods: 1752 children were recruited into a cluster randomized controlled trial conducted on 40 fairly homogeneous public schools (20 for girls and 20 for boys), in Hyderabad, Pakistan. This was ranging from 20-65 children per school. All children were interviewed with questionnaires at baseline.
Results: Few children had no experience of peer violence in …

A Delphi Study: Guidelines For Researchers Working With Teenage Mothers, Alison M. Chamberlain

Nursing Theses and Dissertations

Problem: It is difficult to get teenage mothers to participate in studies, yet some researchers have been successful. Researchers who understand the barriers to conducting studies with a vulnerable population and are guided in ways to overcome these barriers, will experience greater success when doing studies with this group. Improved study methods can lead to larger numbers of teenage mothers who participate in studies. Researchers who follow developmentally appropriate guidelines are more likely to conduct and replicate studies with this population. Access is essential to advance the science related to care for teenage mothers who are at risk for many …

Women’S Perception And Attitude Towards Male Dominancy And Controlling Behaviors, Tazeen S. Ali, Noureen Karamali, Omer Malik

Tazeen Ali

Introduction/Background: The study was conducted in urban Karachi, Pakistan to investigate women’s perceptions and attitudes towards male dominancy, female autonomy, and controlling behavior of husbands. Method: This was investigated in a population based study with a cross-sectional design, involving married women aged 25 to 60 years. A Structured questionnaire developed by World Health Organisation (WHO) on violence was used. Community midwives interviewed these married women living in pre-selected low, middle and upper socio-economic areas of urban Karachi, Pakistan.Findings: This study revealed women’s overall perception regarding male dominancy and controlling behavior and highlighted this attitude, as being acceptable to women. It …

Understanding Of Puberty And Related Health Problems Among Female Adolescents In Karachi, Pakistan, Tazeen S. Ali, Parveen Azam Ali, Humaira Waheed, Azam Ali Memon

Tazeen Ali

Objectives: To understand the level of knowledge, a community based study conducted with the objectives as follows: To estimate the proportion of common facilities available and accessible and frequency of utilizing of it. To estimate the proportion of female adolescent utilizing the availability of facilities. To assess the level of understanding related to puberty and related health problems among female adolescents.Methods: This cross-sectional study was conducted to determine the understanding and level of knowledge related to puberty and related health problems among female adolescents of Karachi, Pakistan. Data was collected from 150 female adolescents between 10-19 years of age. The …