Nursing Commons^™

A Qualitative Study: Why Prolonged Stay In The Recovery Room?, Sharifa B. Lalani, Fauzia Ali, Zeenatkhanu Kanji, Salma Jaffer, Mohammed Ali

School of Nursing & Midwifery, East Africa

There are a number of factors that prolong patients’ stay in the recovery room (RR), which are related to system or clinical issues. However, less has been discovered from the RR nurses about reasons for prolonged patient stay and recommendations to solve this issue. Prolonged patient stay of more than 2 hours in the RR interferes with the primary role of the RR nurse, which is to provide care to immediate postanaesthesia patients. Consequently, this could affect the operating room schedule, normal flow of patients to the RR and discharge to the nursing units.

Implementing Routine Provider-Initiated Hiv Testing In Public Health Care Facilities In Kenya: A Qualitative Descriptive Study Of Nurses' Experiences, Catrin Evans, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Routine 'provider-initiated testing and counselling' (PITC) for HIV has been implemented amidst concern over how consent, confidentiality and counselling (the 3C’s) can be maintained in underresourced health care settings. In Kenya, PITC has been rolled out since 2005, HIV prevalence is 7.1% and over 86% of adults have not been tested. Kenyan nurses are the main cadre implementing PITC but little is known about their experiences of incorporating HIV testing into everyday practice and the challenges faced in maintaining the 3’Cs within their work environments. This study aimed to explore these issues and adopted a qualitative multi-method design using a …

Critical Illness Myopathy, Salima Moez Meherali, Yasmin Parpio, Tazeen Ali

School of Nursing & Midwifery

Critical illness myopathy (CIM) is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit (ICU). This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive …

Sexual Harassment At Work Place: Are You Safe?, Anila Naveed, Ambreen Tharani, Nasreen Alwani

School of Nursing & Midwifery

In today's world women are increasingly participating in the realm of work force, yet they are facing many obstacles in their way. Sexual harassment is one of those obstacles. Sexual harassment at work place is prevalent in every society. It could happen to anyone but women are the targeted victims. Sexual harassment is considered as a traumatic event and the victim may end up in having physical and mental sufferings that hinders a person to work effectively. At an organisational level this may result in decrease work effectiveness, decreased work productivity, high absenteeism, high turnover, and low staff morale. Hence …

The Influence Of Psychosocial Factors On Academic Performance Of Adolescents: A Quality Assurance Project, Saleema A. Gulzar, Tazeen S. Ali, Amina Aijaz, Neesha Hussain

School of Nursing & Midwifery

Adolescence is a time of rapid psychological and physiological changes and is associated with anxiety and mental distress. This project looks at the potential of school-based programs to reduce these negative effects of academic performance in both the short- and long-term. This study was conducted in a private school in Karachi, Pakistan between October 1998 and December 2006 on 305 students with low academic performance. Results show that students scoring low grades had a mean of 55 + 2.8 and postintervention score of 56 + 2.6. The intervention package significantly created a difference in reducing the number of students receiving …

Promoting Motivation Towards Community Health Care: A Qualitative Study From Nurses In Pakistan, Saleema A. Gulzar, Muhammad Shahid Shamim, Ali Khan Khuwaja

School of Nursing & Midwifery

Based on the extensive health care needs of Pakistani population, the idea of Community Health Nursing was introduced in 1985. The educational nursing institutes adopted nursing curriculum in order to produce competent nurses to meet the rising demands of society. However, very few numbers of nurses choose community health nursing as their career pathway in Pakistan. Based on the current observation, enhancing motivation among graduate nurses has always been viewed as a great challenge for the academic nursing institutions. This study was intended to explore motivating and de motivating factors in nurses towards community Health Nursing. By utilizing self concept …

Enhancement Of Critical Thinking In Curriculum Design And Delivery: A Randomized Controlled Trial For Educators, Raisa Gul, Shanaz Cassum, Azra Ahmad, Shehla Khan, Tanveer Saeed, Yasmin Parpio

School of Nursing & Midwifery

Critical thinking is an important outcome criterion of higher education in any discipline including nursing. If nursing programs envisaged preparing graduates who are equipped with critical thinking, then the educators who plan and deliver the programs must exhibit higher level thinking in their teaching practices. This paper presents finding of the 1^st phase of a National level research study that aims to assess, develop and enhance educators’ critical thinking capacity.

A Survey Comparing The Attitudes Toward Perinatal Bereavement Care Of Nurses From Three Asian Cities, Moon Fai Chan, Feng-Lan Lou, David Arthur

School of Nursing & Midwifery

Caring for 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 are unable to deal with the enormity of the parental feelings of loss. The aim of the study was to describe and compare attitudes toward perinatal bereavement care across a sample of nurses working in five obstetrics and gynecology settings from three Asian cities, as well as the factors associated with these attitudes. A survey was conducted, and 573 nurses were recruited from 2006 to 2007. The …

Exploring The Experiences Of Resilience In Muslim Afghan Refugee Children, Zeenatkhanu Kanji, Brenda L. Cameron

School of Nursing & Midwifery, East Africa

The aim of this study was to explore the experiences of Muslim Afghan refugee children living in Canada. War has an impact on a child's life, including education and protection by the family and community. The actual course of events of war can never be told completely due to the occurrence of simultaneous adversities. Hermeneutic photography was used to understand the experiences of Afghan children. Data were collected through photo conversations. Building and sustaining resilience was a theme that emerged from the data analysis. The findings of the study provide a useful guide for education, practice, and policy development to …

How Important Is Patient Privacy? A Reflection, Salima Farooq, Yasmin Parpio, Tazeen Saeed Ali

School of Nursing & Midwifery

Privacy is a basic human right; however, a patient's right to privacy is often violated because health care providers do not fulfill their ethical and professional responsibilities. There is an immediate need to preserve patients' privacy by health care professionals; a standardized policy on patients' privacy is important. This paper aims to analyze the significance of patents' privacy in health care. A case scenario of a pregnant woman from an antenatal setting has been integrated to support the concept of privacy in promoting and advocating patients' right.

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

School of Nursing & Midwifery

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 …

Evaluation Of Laparoscopic Appendectomy Vs. Open Appendectomy: A Retrospective Study At Aga Khan University Hospital, Karachi, Pakistan, Yasmin Vellani, Shaheena Bhatti, Ghina Shamsi, Yasmin Parpio, Tazeen Saeed Ali

School of Nursing & Midwifery

OBJECTIVE: To compare open and laparoscopic appendectomies and to evaluate the level of efficacy of both types of appendectomy performed at Aga Khan University Hospital (AKUH).

METHODS: Based on this strong study rationale, a clinical audit of patient's records was performed to evaluate the significance of this technique as a treatment modality. The study population comprised of patients with appendicitis admitted in the Department of Surgery from January 2004 to December 2004. The patients' charts were reviewed to ascertain whether the procedure was done as an acute case or as an elective procedure. The predictor variables explored in this study …

Does “Asymptomatic” Mean Without Symptoms For Those Living With Hiv Infection?, Suzanne Willard, William L. Holzemer, Dean J. Wantland, Yvette P. Cuca, Kenn M. Kirksey, Carmen J. Portillo, Inge B. Corless, Marta Rivero-Méndez, María E. Rosa, Patrice K. Nicholas, Mary Jane Hamilton, Elizabeth Sefcik, Jeanne Kemppainen, Gladys Canaval, Linda Robinson, Shahnaz Moezzi, Sarie Human, John Arudo, Lucille Sanzero Eller, Eli Bunch, Pamela J. Dole, Christopher Coleman, Kathleen Nokes, Nancy R. Reynolds, Yun-Fang Tsai, Mary Maryland, Joachim Voss, Teri Lindgren

School of Nursing & Midwifery, East Africa

Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as ‘‘asymptomatic’’ by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003 - 2005 and 2005 - 2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and …

Domestic Violence Among Pakistani Women: An Insight Into Literature, Azmat J. Khan, Tazeen S. Ali, Ali K. Khuwaja

School of Nursing & Midwifery

The objectives of this search were to estimate the burden of domestic violence, its contributing factors and strategies based on literature review for the prevention and control of domestic violence. Published literature about domestic violence in Pakistan during the years 1998 to 2008 was analyzed and scrutinized. This article is based on the searched result of 200 articles published in the English language from which finally 13 articles were selected. Search terms included “Violence”, “Domestic violence”, “Domestic violence in Pakistan” and “Strategies and Recommendations for Prevention of Domestic violence”. According to these studies, the intimate partners' violence is reported as …

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

School of Nursing & Midwifery

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 …

Experiences Of African Immigrant Women Living With Hiv In The U.K.: Implications For Health Professionals, Eunice Ndirangu, Catrin Evans

School of Nursing & Midwifery, East Africa

In the U.K. immigrant women from Africa constitute an increasingly large proportion of newly diagnosed cases of HIV. A significant minority of these are refugees and asylum seekers. Very little is known about their experiences of living with HIV/AIDS, their psychosocial needs or their views of health care provision. This paper reports the results of a qualitative study that explored these issues by interviewing eight African women living with HIV in the British city of Nottingham. Women’s ability to live positively with HIV was found to be strongly shaped by their migration history, their legal status, their experience of AIDS-related …

The Importance Of Hiv Specialist Services For African Women Living With Hiv In Nottingham: Results Of A Qualitative Study, Eunice Ndirangu, Catrin Evans

School of Nursing & Midwifery, East Africa

This article reports the results of a qualitative study of the experiences of African women living with HIV in Nottingham, UK. Globally, sub-Saharan Africa is the region most severely affected by the HIV pandemic [1]. This pattern is also reflected in the UK where African migrants make up 27% of those diagnosed with HIV despite the fact that they constitute less than 1% of the population [2-4]. Healthcare staff play a central role in meeting the prevention and care needs of people living with HIV/AIDS [5]. In contexts of increasing migration, health workers are called upon to recognise the diverse …

'People Are Creating Policy Up There, They Are Not Coming Down': Nurses' Views On The Expansion Of Routine Provider-Initiated Hiv Testing And Counselling In Nairobi, Kenya., Catrin Evans, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

In this report, we present selected findings from an exploratory piece of qualitative research on HIV testing that was undertaken in 2007-2008 with nurses in Nairobi, Kenya. At the same time, we share our own story of how this research came about and how NHIVNA research funding was able to lay the foundations for a larger study that will hopefully give voice to patients and HIV nurses in Nairobi and will develop HIV nursing research capacity in the country.

Ranzcp Experiences In Establishing And Progressing An Externally Focused Mental Health Policy And Partnership Agenda, Sharon Brownie, Julian Freidin

School of Nursing & Midwifery, East Africa

Objective: This paper traces the background of involvement and increasing external activity of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in the policy and project area.

Conclusions: Throughout 2008, representatives of the RANZCP paused to review progress and celebrate successes in the implementation of the College's stated aim to develop an externally focussed policy agenda. A summary of key activities across the past 4–5 years is outlined, including the key leadership role undertaken by the RANZCP in the recent formation of the Mental Health Professionals Association's partnership. Tracing the history of the establishment of the RANZCP …

Can Rote Learners Be Transformed Into Critical Thinkers Through A Concept – Mapping Intervention?, Raisa B. Gul, Shanaz Hussein Cassum, Khairulnissa Ajani

Book Chapters / Conference Papers

Critical thinking is an important outcome of higher education in any discipline. International literature reveals that teaching strategies—such as reflections, self-directed learning, questioning, and concept mapping—which ask for active engagement of students in their learning, foster critical thinking. Social context of the learning environment, and the instructor’s competence and approach to teaching also influence students’ critical thinking abilities. Contrary to the required teaching practices, didactic teaching and rote learning are still prevalent in most teaching institutions and disciplines in Pakistan. The focus of this paper is to report on the process and findings of a quasi-experimental study in which students …

Admission Criteria And Subsequent Academic Performance Of General Nursing Diploma Students, Parveen Azam Ali

School of Nursing & Midwifery

OBJECTIVE: To determine the relationship between admission criteria used to select students and their subsequent academic performance in general nursing diploma Programme in the province of Sindh.

METHODS: Using a descriptive co-relational study design, data was collected retrospectively from records of the entire nursing student population of the batch of 2004. Using multiple linear regression analysis method, three regression models were developed to identify the group of variables that could predict academic performance of the students in the three-year general nursing diploma programme.

RESULTS: Results identified a significant relationship between admission criteria and subsequent academic performance of the students in …

Displaced And Dispossessed: Caring For The World’S Refugees, Shela Akbar Ali Hirani

School of Nursing & Midwifery

No abstract provided.

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

School of Nursing & Midwifery

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 …

Intent To Migrate Among Nursing Students In Uganda Measures Of The Brain Drain In The Next Generation Of Health Professionals, Lisa Nguyen, Steven Ropers, Esther Nderitu, Anneke Zuyderduin, Sam Luboga, Amy Hagopian

School of Nursing & Midwifery, East Africa

Background: There is significant concern about the worldwide migration of nursing professionals from low-income countries to rich ones, as nurses are lured to fill the large number of vacancies in upper-income countries. This study explores the views of nursing students in Uganda to assess their views on practice options and their intentions to migrate.

Methods: Anonymous questionnaires were distributed to nursing students at the Makerere Nursing School and Aga Khan University Nursing School in Kampala, Uganda, during July 2006, using convenience sampling methods, with 139 participants. Two focus groups were also conducted at one university.

Results: Most (70%) of the …

Prevalence And Factors Associated With Postpartum Vaginal Infection In The Khyber Agency Federally Administered Tribal Areas, Pakistan, Nasreen Ghani, Rafat Jan Rukanuddin, Tazeen S. Ali

School of Nursing & Midwifery

Objective: To estimate the prevalence and to identify the factors associated with vaginal infection among the married women between the ages of 15-49 years residing in the Khyber Agency (FATA), Pakistan.
Methods: A cross-sectional study was conducted in the month of July 2005 on 1084 mothers by using random sampling strategy in Khyber Agency Pakistan by trained nurses. The descriptive and multivariate statistics were computed.
Results: The multivariate analysis showed that the associated factors with vaginal infection were the use of unhygienic material to soak up the lochia [aOR=3.45, 95% CI (1.36, 8.75)], bathing after 40 days [aOR=2.10, 95% …

Strategies And Recommendations For Prevention And Control Of Domestic Violence Against Women In Pakistan, Tazeen S. Ali, N Khan

School of Nursing & Midwifery

Domestic violence is highly prevalent in Pakistan. This paper proposes the strategies based on literature review, for the prevention and control of domestic violence. The reported causes for domestic violence against women include women's low educational levels, low empowerment, and least opportunities to indulge in political activities; wrong interpretations of religious, traditional and cultural norms in the society; poverty; dowry system; women's suppressed autonomy and males' addiction to alcohol. Through this article, we have attempted to highlight the need to recognize the domestic violence against women as an important issue and to enhance educational and health facilities for the prevention …

Adoption Practices Among Couples With Secondary Infertility In Karachi: A Triangulation Study Design, Tazeen S. Ali, Neelofar Sami

School of Nursing & Midwifery

Objective: To explore the perceptions and experiences of couples with secondary infertility regarding adoption practices; to estimate the prevalence of adoption among couples with secondary infertility, and to study the adopted child preference pattern.
Methods: To fulfill the objectives of the study both qualitative and quantitative study designs were utilized. In qualitative explorative study design, three Focus Group discussions were conducted with married fertile women to explore their perceptions for adoption practices. Moreover, eight in-depth interviews were conducted with women with secondary infertility to explore their experiences. For quantitative methodology, a case series of 400 secondary infertile couples was conducted. …

Are Unhygienic Practices During The Menstrual, Partum And Postpartum Periods Risk Factors For Secondary Infertility?, Tazeen S. Ali, Neelofar Sami, Ali Khan Khuwaja

School of Nursing & Midwifery

This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighbourhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery at an unclean place (adjusted odds ratio …

Evaluation Of Efficacy Of Self Breast Examination For Breast Cancer Prevention: A Cost Effective Screening Tool, Sanah Baig, Tazeen S. Ali

School of Nursing & Midwifery

Breast cancer is the most prevalent neoplasm among females and every year the number of associated deaths increases so that there is a dire need for implementation of cancer screening and early detection. A survey conducted by various locally organised cancer registries indicated breast cancer to be the most prevalent cancer among females and the second most common cause of cancer deaths among Pakistani women. Since Pakistani females do not generally engage in screening practices we argue that nurses and lady health workers should team up to educate women for the possible early detection of cancer using Self Breast Examination …

Health Seeking Behavior Of Couples With Secondary Infertility, Neelofar Sami, Tazeen S. Ali

School of Nursing & Midwifery

OBJECTIVE: To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi. DESIGN: A descriptive case series.
PLACE AND DURATION OF STUDY: The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003. PATIENTS AND METHODS: All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple …