Medicine and Health Sciences Commons^™

Development, Validation, And Diagnostic Performance Of A Novel Radiomic Model For Predicting Prostate Cancer Recurrence, Linda M. Huynh

Theses & Dissertations

Multi-parametric magnetic resonance imaging (MP-MRI)-derived radiomics have been shown to capture sub-visual patterns for the quantitative characterization of prostate cancer (PC) phenotypes. The present dissertation seeks to develop, evaluate, and compare the performance of an MRI-derived radiomic model for the prediction of PC recurrence following definitive treatment with radical prostatectomy (RP).

MP-MRI was obtained from 339 patients who had a minimum of 2 years follow-up following RP at three institutions. The prostate was manually delineated as the region of interest and 924 radiomic features were extracted. All features were evaluated for stability via intraclass correlation coefficient (ICC) and image normalization …

Multimodal Investigations For The Identification Of Surgically Relevant Brain Areas, Kevin Tyner

Theses & Dissertations

Epilepsy is a neurological disease leading to recurrent and unpredictable seizures. Patients can be diagnosed as focal onset, where the seizure focus resides in one hemisphere; generalized onset, where seizure foci reside in both hemispheres; or unknown onset. Anti-seizure medications are the first line of treatment, and those whose seizures cannot be controlled with medication are diagnosed with drug-resistant epilepsy (DRE). For patients diagnosed with focal onset epilepsy to achieve seizure freedom, surgical resection of the epileptogenic zone (EZ), the region of the brain that is both necessary and sufficient for initiating seizures, is required. The EZ is a theoretical …

The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali

Theses & Dissertations

Introduction: Pediatric oncology nurses in Pakistan are at the forefront of caring for young cancer patients. In Pakistan, thousands of children are diagnosed with cancer every year, however the country's healthcare system lacks a comprehensive National cancer registry. Pediatric oncology nurses face high stress levels due to the demanding nature of their work, lack of specialized training, and communication challenges with patients and families. This study aims to explore the prevalence of stress and its predictors among these nurses in Pakistan, addressing a significant research gap.
Purpose: The purpose for the study was to measure stress and identify its predictors …

Effect Of Customer Incivility And Emotional Exhaustion On Job Satisfaction And Turnover Intentions In Nurses At A Tertiary Care Cancer Hospital In Pakistan, Saima Rubab

Theses & Dissertations

Background: Workplace incivility significantly impacts nurses' job satisfaction and turnover intentions. However, the incivility of the patients and their family emotionally drain health care providers. Subsequently, the lack of support from one’s organisation and job dissatisfaction contribute to healthcare employee turnover.
Aim of the Study: The study explores the associations between customer incivility and emotional exhaustion and determines whether they contribute to or affect the nurses’ job satisfaction and turnover intentions.
Methodology: The study used a cross-Sectional analytical study design to explore the study questions. A well-defined questionnaire was used to collect the data from the target population of staff …

Evaluating The Symptoms And Treatment-Related Knowledge Of Cancer Patients Receiving Chemotherapy In A Tertiary Care Hospital, Kiran Nawaz Ali

Theses & Dissertations

Background: Cancer has become the leading source of mortality and morbidity worldwide. Its prevalence is rising and high-risk behaviours are being adopted by the people in society. Knowledge about cancer and its management helps in adjusting the resource allocations and in terms of public health policy. Moreover, patient education about symptoms, treatment, and side effects is crucial and must be addressed.
Knowledge about cancer, its side effects, and the possible treatment outcomes is essential, as it helps in deciding about adherence to the treatment. It is observed that many oncology patients have information gaps related to cancer and chemotherapy. However, …

Assessing Medication Compliance And The Usage Of Complementary Therapies Effecting Hba1c Among Patients With Type 2 Diabetes Mellitus In A Tertiary Care Hospital In Karachi, Pakistan, Neelam Nasruddin

Theses & Dissertations

Background: Diabetes Mellitus is a chronic illness. It remains to be a major public health matter and a financial burden on the medical system worldwide. This condition can be managed and better treatment strategies and compliance can reduce the risk of complications. In 2022, there will be around 33,000,000 new cases of diabetes worldwide, with 26.7% of the adults in Pakistan being affected, predicts the (International Diabetes Federation, 2022). However, it is observed that most individuals turn to complementary and alternative methods (CAM)/Traditional medicine because of the rising cost of therapy, adverse effects of anti-diabetic medications, and accessibility concerns.
Purpose: …

Assessment Of Organizational Readiness Towards Electronic Health Records In A Tertiary Care Hospital, Karachi, Pakistan, A Quantitative Analytical Cross-Sectional Study, Muhammad Javeed

Theses & Dissertations

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital …

Evaluation Of Caring Behaviors In High-Fidelity Simulation Following A Caring Concept Educational Intervention, Debra Ann Mcwilliams

Theses & Dissertations

Background.

Simulation has created a new paradigm in nursing education. Behaviors that demonstrate caring are important aspects of quality nursing practice. Nursing education needs to integrate opportunities to teach caring, and simulation is an ideal environment to do this. Faculty must assist nursing students to establish competence in psychomotor, cognitive, and the affective domains of learning. Many of the widely used, standardized scenarios in simulation predominantly focus on critical-thinking skills while marginalizing the demonstration of caring behaviors.

Purpose.

The purpose of this quantitative study was to examine the effect of a caring concept educational intervention (CCEI) in students’ self-reported confidence …

Central Activation Of Orl-1 Receptors In Heart Failure Models, Jeffrey Angell

Theses & Dissertations

Heart failure is a prevalent and debilitating disease associated with high morbidity and mortality rates worldwide and is the leading cause of death in the United States. While various therapeutic strategies have been developed and approved to manage heart failure, exploration of novel targets and mechanisms are essential for improving patient outcomes. This thesis investigates the therapeutic potential of the central activation of opioid receptor-like 1 (ORL-1) by nociceptin in a rodent heart failure model.

Furthermore, this study aims to elucidate the central mechanisms underlying nociceptin induced cardiovascular and renal effects in heart failure. This involves investigating neuronal pathways and …

Using Simulation To Assess Knowledge And Attitude Amongst Healthcare Provider Regarding Cardiopulmonary Resuscitation At A Tertiary Care Hospital In Karachi, Pakistan- A Pre And Post Test Qausi Experimental Study, Nausheen Barkat Ali Noorani

Theses & Dissertations

No abstract provided.

Prevalence Of Type A And Type B Personality Among Undergraduate Nursing Students At Private School Of Nursing Karachi Pakistan: A Cross-Sectional Analytical Study, Farhana Shaheen

Theses & Dissertations

Background: Academic institutions strive for exceptional graduates. However, personality and learning psychology affect student performance. Type A personality students may develop heart palpitations due to impatience and stress. They are less sociable than Type B personalities but more idealistic, competitive, and deadline oriented. These disparities among personalities may impair their academic and job success, especially in healthcare, where interpersonal skills are vital.
Aims: The primary aim of the study was to find out the prevalence of Type A and Type B personality among undergraduate nursing students and to find the association between personality Types and academic years.
Methodology: In this …

Exploring The Final Year Nursing Students’ Anticipatory Expectations Related To The Transition To Nursing Interns And Challenges Faced By Nursing Interns During Transition, Madrika Mirza Kanjiani

Theses & Dissertations

Background: The transition period of new graduate nurses necessitates major adjustments as they transition from an organized learning environment to a more independent and challenging work environment. Most of the transitional challenges and concerns remain unaddressed resulting in a difficult transition. This study can aid in identifying the problems and the anticipated expectations of final-year nursing students to bridge the gap between academic training and professional practice, resulting in a smoother transition for new graduate nurses.
Purpose: The current study aimed to identify the perceptions of final-year baccalaureate nursing students regarding their anticipated expectations related to the transition from being …

Association Between Self-Esteem And Perceived Social Support In Patients With Facial Burn Scars At Burn And Plastic Surgery Centre Peshawar, Pakistan, Rafiullah Shafiullah

Theses & Dissertations

Background: Burn injuries, a significant global public health challenge, cause significant morbidity and psychological problems, particularly in low to middle-income countries. These injuries can lead to social isolation, fear, and despair, thus adding to victims' psychological burden. However, the perception of social assistance helps burn sufferers cope better post-trauma and improve their self-esteem.
Purpose: The purpose of the study was to investigate the association between self-esteem and perceived social support in patients with facial burn scars, and thus contribute to a better understanding of the psychological well-being of people with facial burn scars.
Methodology: A quantitative cross-sectional study was conducted …

The Perception Of Nurses And Doctors On Interprofessional Collaboration (Ipc) In The Cicu And Ccu Setting Of A Tertiary Care, Private Hospital, Karachi, Pakistan, Rakhshanda Zareen

Theses & Dissertations

Background: In critical care units, collaboration among professionals is essential to achieving the best possible patient outcomes, high-quality care, and efficient use of resources. Thus, this study explored the perceptions of nurses and doctors regarding interprofessional collaboration in critical care units (CCU) and cardiac intensive care units (CICU).
Purpose: The study aimed to understand the perception of nurses and doctors regarding IPC. The study also aimed to gather information regarding the factors associated with nurse-physician collaboration in CICU and CCU.
Methodology: A qualitative descriptive approach was used. In-depth interviews with a total of eight doctors and nurses in the CICU …

The Knowledge And Attitude Regarding Pubertal Changes Among Adolescent Males In Urban Karachi, Pakistan, Sabah Muhammad Nazim

Theses & Dissertations

Background: Adolescence (the period between childhood and adulthood) is characterised by significant changes in bodily functions, along with psychological and cognitive growth. The unanticipated changes in that phase (especially related to sexuality) can cause adolescents embarrassment and distress, thus impacting their well-being and development.
Purpose: The study aimed to evaluate the level of knowledge and attitudes among male adolescents residing in urban Karachi, Pakistan, specifically concerning pubertal changes and health. The primary focus was to gather information about how well these adolescents understand the physical and emotional transformations associated with puberty and their overall awareness and attitude towards pubertal health …

Exploring Midwives’ Challenges And Strategies To Provide Care In Maternity Settings During The Harsh Winter Weather In The Northern Areas Of Pakistan: A Qualitative Study, Sana Sultan

Theses & Dissertations

Background: Midwives play a vital role in enhancing the quality of care and achieving substantial reductions in maternal and newborn mortality rates. However, in Gilgit Baltistan, the harsh winter weather and frequent heavy snowfall present distinct challenges for midwives providing essential maternal care. These challenges can lead to an increased risk of maternal infections and newborn hypothermia. Consequently, the limited accessibility to healthcare facilities due to frequent harsh winter weather and the resulting scarcity of resources like heating, electricity, and water exacerbate the situation.
Objective: The study aims to explore the challenges and barriers midwives face in maternity settings and …

Mothers’ Perspectives On The Use Of Social Media For Receiving Professional Support In Enhancing Their Lactation Self-Efficacy: A Qualitative Descriptive Exploratory Study, Mehtab Lalwani

Theses & Dissertations

Background: Inadequate breastfeeding support and low exclusive breastfeeding rates in Pakistan underpin the need for effective strategies to enhance lactation self-efficacy among mothers. Social media has emerged as a promising professional support and information dissemination avenue. However, concerns about the accuracy of online advice highlight the importance of investigating mothers' perspectives regarding utilizing social media for professional breastfeeding support.
Purpose: This study aims to investigate how mothers perceive social media for receiving professional breastfeeding support, to enhance their lactation self-efficacy.
Methodology: This exploratory-descriptive qualitative study utilized in-depth semi-structured interviews with 12 breastfeeding mothers, purposively recruited from a tertiary care hospital …

Family Needs Of Patients Admitted To Intensive Care Units At A Tertiary Care Hospital, Karachi, Pakistan An Analytical Cross-Sectional Study, Tariq Ali

Theses & Dissertations

Background: The admission of patients to the ICU is a distressing emergency. Family members of ICU patients suffer from anxiety and depression compounded by disrupted routines and role conflicts. Nurses often prioritise patient care over family support, while the family goes ignored. The family members staying in hospital have different physical and psychological needs. Family members frequently bear the responsibility of making critical decisions for the patients. The unmet important family needs add to their stress and anxiety.
Purpose: This study aimed to assess the self-perceived importance of family needs in the ICU using the CCFNI Scale and identifying socio-demographic …

Perceptions Of Intensive Care Nurses And Physicians Regarding Interprofessional Collaboration In Intensive Care Unit Of A Tertiary Care Hospital In Karachi: An Exploratory Qualitative Study, Waheed Ullah

Theses & Dissertations

Background: Interprofessional Collaboration (IPC) is crucial in healthcare, particularly in intensive care units (ICUs). Effective Interprofessional Collaboration between physicians and nurses in patient care can reduce hospital stays, improve the quality of care, and enhance the health outcomes of patients. It has been determined that Interprofessional Collaboration (IPC) is a key policy method foming healthcare personnel and patient safety challenges and improving the healthcare organization.
Purpose: This study aims to explore the perceptions of ICU nurses and physicians regarding IPC in a tertiary care hospital in Karachi, Pakistan. It also investigates the factors that facilitate and limit IPC, thereby impacting …

Association Between Patient Safety Culture And Missed Nursing Care Among Nurses At A Tertiary Care Teaching Hospital In Karachi, Pakistan, Zaifullah Khan

Theses & Dissertations

Background: This study seeks to investigate the relationship between Patient Safety Culture (PSC) and Missed Nursing Care (MNC) in a tertiary care teaching hospital in Karachi, Pakistan. It stands out for its focus on healthcare setting in a developing country, addressing a significant gap in existing literature.
Purpose: The aim is to assess PSC, determine the prevalence of MNC among nurses, investigate their correlation, and examine the impact of demographic factors, including identifying the most frequent missed nursing care and their underlying reasons, providing valuable insights for healthcare systems in developing countries.
Methods: A cross-sectional analytical approach was adopted, involving …

Predictors Of Presenteeism Among Nurses Working At A Tertiary Care Hospital In Karachi, Pakistan: A Cross-Sectional Analytical Study, Farhan Shahzad

Theses & Dissertations

Background: Nurses are considered the backbone of hospitals who provide care for their patients despite being ill. This phenomenon of working while ill or suffering from a health condition is called presenteeism. Presenteeism is becoming a more prominent problem among healthcare providers, especially nurses. It has a variety of negative effects, including stress and burnout, decline in productivity and performance, and ultimately results in decreased quality of care.
Objective: The objective of this study was to compute the presenteeism score and predict its associated factors among nurses working at a tertiary care hospital in Karachi, Pakistan.
Methodology: A cross-sectional analytical …

Nurses’ Compliance With Handover Practices In Adult Medical Surgical Units At A Tertiary Care Hospital In Karachi, Pakistan, Amber Qasim Ali

Theses & Dissertations

Background: The exchange of the shift changeover report of patient, from nurse to nurse at the patient's bedside is known as "bedside handover." Although this method is becoming more and more popular in the nursing sector, not many people genuinely practice it.
Purpose: To determine the different factors impacting nurses' compliance and to evaluate the compliance rate of nurses to comply with bedside handover guidelines.
Methods: A cross-sectional observational study was conducted in the medical surgical ward at the Aga Khan University Hospital, Karachi. During the study, the structured bedside handover technique known as "kardex," which adheres to SBAR (Situation, …

Perception Of Students As Partners In Learning Among Students And Faculty Members Of Sonam Karachi, Pakistan, Anum Shiraz Gujrati

Theses & Dissertations

Background: Students as Partners (SaP) has emerged as a student-centred approach where students are taken as active partners in determining learning outcomes and pedagogies rather than being merely passive learners and consumers in Higher Education (HE). It shifts the focus from the teacher-centred to the student learning environment and from a product to process-orientated outcomes. There is still a need to explore the perception of students as partners in HE among undergraduate and graduate nursing students and faculty members.
Purpose: The purpose of the study is to explore the perception of students and faculty members regarding students as partners in …

Nurses' Compliance With Central Line Maintenance (Handling) Guidelines At A Tertiary Care Setting In Karachi, Pakistan- A Descriptive Cross-Sectional Study, Alina Amir Ali

Theses & Dissertations

Background: Central venous catheters (CVCs) are integral to modern healthcare, facilitating critical treatments. However, the risk of complications, particularly infections, necessitates strict adherence to central line maintenance protocols. This study explores the compliance of nurses in executing these protocols.
Purpose: In a tertiary care facility in Karachi, Pakistan, this study sought to evaluate nurses' adherence to each item on the central line management checklist as well as the checklist's total adherence in the Special Care Units.
Method: A total of 119 registered nurses were assessed, using a quantitative structured observational design for central line handling in adult medical surgical special …

Parents’ Emotional And Psychological Perspective Of Caring Children With Oncological Disorders: A Descriptive Qualitative Study, Ambreen Navroz Ali Salyani

Theses & Dissertations

Background: Childhood cancer has a profound effect on the emotional and psychological well-being of parents, yet often their own psychological health is overlooked as the primary focus while treating the child. These parents silently suffer from psychological distress while caring for their children. They use their own coping strategies to overcome the situation. However, limited studies have been carried out in low- and middle-income countries (LMIC) regarding parents’ emotional and psychological perspectives of caring their children with oncological disorder.
Purpose: The objective of this study was to explore the psychological perspectives that parents of children with cancer diagnosis, treatment, social …

A Mixed Methodological Approach To Study The Feasibility Of An End-Of-Life Care Pathway, Noureen Azizullah Mistry

Theses & Dissertations

Background: The growing significance of end-of-life care in response to the increasing prevalence of chronic illnesses and aging populations has prompted recognition of the need for patient-centred care. Care pathways are employed worldwide to offer comprehensive end-of-life care to patients in various healthcare settings. In Pakistan, there is a recognised need to evaluate the feasibility of introducing an end-of-life care pathway.
Objectives: This study aimed to (a) determine the feasibility of using an end-of-life care pathway for hospital-based and home-based palliative care patients, and (b) explore the experiences and opinions of registered nurses piloting the pathway.
Methods: An explanatory sequential …

Exploring Experiences Of Alarm Response And Alarm Fatigue Among Nurses Working In The Icu Of A Tertiary Care Hospital In Karachi, Pakistan: A Qualitative Study, Shenila Shamsuddin

Theses & Dissertations

Background: Alarm fatigue is a significant concern within the healthcare sector, marked by the excessive exposure of healthcare practitioners to clinical alarms. This prolonged exposure can result in desensitization and delay nurse’s responsiveness to vital warnings. The occurrence of inaccurate alarms intensifies desensitization, undermining confidence in alarm systems and potentially leading nurses to ignore alarms. Alarm fatigue is a prevalent issue of worldwide significance, which calls for more investigation to effectively tackle these issues and enhance understanding of alarm systems to get the best possible treatment results. However, there is a lack of study undertaken in Pakistan about the investigation …

Qualitative Research Exploring Perceptions About Umbilical Cord Care Practices Among Mothers/Caregivers Of Neonates Admitted At A Children Hospital Managed Through A Public-Private Partnership, Ruqia Yasmeen

Theses & Dissertations

Background: Newborns in LMICs face high mortality rates. Multiple factors contribute to these moralities. Among these are unhygienic conditions, and infection of the umbilical cord stump. Unhealthy cultural practices, lack of awareness, myths, and socioeconomic status are key barriers to newborn care. In Pakistan, nearly 300,000 newborns die annually, highlighting the need for improved newborn care.
Objectives: This study is aimed to explore the perceptions and knowledge of mothers/caregivers about umbilical cord care.
Methodology: The qualitative descriptive exploratory design was employed to explore mothers' and caregivers' understanding of cord care through in-depth interviews. Fifteen interviews were conducted at a children's …

Assessment Of Preoperative Anxiety, Its Contributing Factors, And Impact On Immediate Postoperative Outcomes Among Cardiac Surgery Patients - A Cross-Sectional Study, Naveen Nizar Ali

Theses & Dissertations

Background: Preoperative anxiety is characterized by an intense sensation of fear, apprehension, and nervousness. In the domain of cardiac surgery, the assessment and management of preoperative anxiety is of paramount importance, as it plays a pivotal role in shaping the patient's surgical experience and immediate postoperative outcomes. While the etiology of preoperative anxiety is multifaceted, the influence of sociodemographic factors in this context is of paramount importance. However, limited studies have been conducted in developing countries regarding this phenomenon.
Purpose: The study aimed to identify the frequency of preoperative anxiety, its contributing factors, and its impact on immediate postoperative outcomes …

Exploring The Patients’ And Family Members’ Perspectives On Home-Based Palliative Care, Nadia Sultan Ali

Theses & Dissertations

Background: Home health care is considered as a partial substitute for institutional long-term care, because patients and families with known poor prognoses prefer to stay home with their loved ones and people mostly cannot bear the cost of care at the hospital. Therefore, the importance of home-based palliative care is raised via a shared and coordinated model for saving lives through care.
Purpose: To explore patients' and family members' perspectives and experiences of receiving home-based palliative care services.
Method: This was a qualitative exploratory study conducted in Karachi, targeting patients and family members receiving home-based palliative care services. The data …