Nursing Midwifery Commons^™

Palliative Care: An Alien Concept In Pakistan, Nadia Pyarali Mulji, Sumaira Sachwani

School of Nursing & Midwifery

Every living being has to die. Respecting a dying individual’s personal values and preferences is a challenge. We live in a culture where family decisions are given priority over individual’s wish. To address this challenge, a concept of palliative or comfort care is newly introduced in Pakistan. Palliative care is a multidisciplinary specialty that emphases on prevention and relieving suffering as well as supporting the optimal quality of life of patients and their families (Bailey, Harman, Bruera, Arnold, & Savarese,2014). In Pakistan, the concept of palliative care is like a newborn baby who needs a lot of ethical attention in …

Practices Of Faculty Members Regarding Teaching And Learning Strategies In Nursing Education, Shams Ul Huda, Tazeen Saeed Ali, Kashmira Nanji, Shanaz Hussein Cassum

School of Nursing & Midwifery

Objective: To determine the different teaching learning strategies utilized, percentage of faculty members utilizing these teaching strategies and faculty perceptions regarding effectiveness of these in undergraduate nursing degree programs in Khyber Pakhtunkhwa (KPK), Pakistan.
Methodology: Cross sectional descriptive design was used to conduct this study. The sample size was 42. The faculty members were recruited from different nursing institutes offering degree programs in KPK, Pakistan. Statistical analysis was done using SPSS & STAT.
Results:Discussion, lecture, group discussion, and PPT were used by 78.6%, 73.8%, 73.8%, and 69% of the faculty members, respectively. However, other learning strategies like debate, PBL, …

Quality Of Life And Its Determinants In Adult Cancer Patients Undergoing Chemotherapy Treatment In Pakistan., Parveen Chagani, Yasmin Parpio, Raisa B. Gul, Adnan Jabbar

School of Nursing & Midwifery

Objective:

Cancer is a leading cause of death worldwide. Likewise, in Pakistan, it is a major health problem, with an approximate increase each year. Cancer treatment, particularly chemotherapy, produces a detrimental effect on individuals' well-being. Since the past few years, quality of life (QOL) is considered as the primary goal of cancer treatment in patients' survival. This study aimed to assess the QOL and its determinants in adult cancer patients undergoing chemotherapy treatment.

Methods:

An analytical cross-sectional design was employed to achieve the study objectives, utilizing consecutive sampling technique. A total of 150 adult (>19 years) cancer patients were …

Nurse Teachers’ Conceptions And Practices Of Written Feedback In Karachi., Sobia Idrees, Raisa B. Gul, Ambreen Tharani, Syeda Kauser Ali

School of Nursing & Midwifery

Background:

Written Feedback (WFB) plays a significant role in student’s learning in terms of improvement of their academic writing skills. However, the quality of WFB may be affected by various personal and contextual factors. This study aimed to identify nurse teachers’ conceptions and practices of WFB on written assignments in nursing degree offering institutions in Karachi, Pakistan.

Methods:

A cross-sectional descriptive study design was used to answer the study questions. The study was conducted at 11 nursing schools in Karachi by recruiting those teachers who were teaching in nursing degree programs. The sample size of the study consists of 80 …

Infection Control In Labor And Delivery Room, Learning From The Small Hospital Based Project, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

Background: It has been estimated that around 36% of the neonatal deaths occur due to infection in the lower and middle income countries. Infection control is a more substantial area of concern, particularly in Labor and delivery room. Multiple factors can cause infection in the labor room, therefore it is important to assess various factors of maternal and neonatal infection. Hence we explored multiple factors through this project and developed the action plan to address those factors effectively.
Methods: During our Leadership and Management course, we conducted a project in Labor room pertaining to a prevalent issue. The whole process …

Creating Enabling Environment For Student Engagement: Faculty Practices Of Critical Thinking, Shanaz Hussein Cassum, Raisa B. Gul

School of Nursing & Midwifery

Critical thinking (CT) is considered an important attribute in practice disciplines and faculty members in nursing, medicine, and education are expected to facilitate the development of CT in their graduates so that these individuals can be critical, reflective, competent, and caring professionals and service providers (Distler, 2007; Shiau & Chen, 2008; Worell & Profetto-McGrath, 2007). When students are actively engaged in their learning, and classrooms have an enabling environment, critical thinking is promoted. Teachers must reflect upon their teaching pedagogy when students do not participate in stimulating discussions, or asks questions in class. Research suggests that lack of understanding of …

Attitude Towards Gender Roles And Violence Against Women And Girls (Vawg): Baseline Findings From An Rct Of 1752 Youths In Pakistan, Tazeen S. Ali, Rozina Karmaliani, Judith Mcfarlane, Hussain M. A. Khuwaja, Yasmeen Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Violence against women is driven by gender norms that normalize and justify gender inequality and violence. Gender norms are substantially shaped during adolescence. Programs offered through schools offer an opportunity to influence gender attitudes toward gender equity if we understand these to be partly shaped by peers and the school environment.
Objective: We present an analysis of the baseline research conducted for a randomized controlled trial with 1752 grade 6 boys and girls and their attitudes toward gender roles, VAWG, and associated factors.
Methods: We used baseline data from a cluster randomised control study. Interviews were …

Cultural Practices Of Rearing Preterm Infants: A Qualitative Study In A Tertiary Care Hospital, Karachi, Pakistan, Salima Sulaiman Gulamani, Ambreen Tharani, Sharifa Bashir Lalani, Kiran Shaikh

School of Nursing & Midwifery

The research work explores the cultural practices of feeding and hygiene of preterm infants in the Pakistani context. A Qualitative descriptive-exploratory design has been used. Purposive sampling was utilized to recruit 17 mothers, who met inclusion criteria from a largest government tertiary care hospital in Karachi, Pakistan. The semi-structured interview was used to collect the data, which lasted for approximately 45-60 minutes. Thematic analysis was conducted to analyze the key findings of the study. Welcoming newborn with 'honey' and herbal remedies were reported as a common ritual among mothers. Findings revealed differences in the time period of initial bath given …

Association Of Awareness About Hepatitis C Infection With Patterns Of Health Seeking Behavior Among Hepatitis C Patients In Karachi, Pakistan, Shahina S. Pirani, Saleema Allana, Tazeen S. Ali, Faisal Wasim Ismail

School of Nursing & Midwifery

Background: Hepatitis C infection is one of the significant causes of morbidity and mortality throughout the world. In Pakistan, hepatitis C infection rate is 4.8%, which is the second highest prevalence rate among all developing countries. This study aimed to identify the association between awareness about hepatitis C infection and pattern of health seeking behavior among patients living with hepatitis C in Karachi, Pakistan.
Methods: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan between March and May 2013. Data were …

Exploring The Impact Of Gender Inequities On The Promotion Of Cardiovascular Health Of Women In Pakistan, Rubina Barolia, Alexander M. Clark, Gina M. Higginbottom

School of Nursing & Midwifery

Cardiovascular disease exerts an enormous burden on women's health. The intake of a healthy diet may reduce this burden. However, social norms and economic constraints are often factors that restrain women from paying attention to their diet. Underpinned by critical realism, this study explores how gender/sex influences decision-making regarding food consumption among women of low socioeconomic status (SES). The study was carried out at two cardiac facilities in Karachi, Pakistan, on 24 participants (male and female from different ethnic backgrounds), who had received health education. Using an interpretive descriptive approach, the study identified major barriers to a healthy diet: proscribed …

Does Empowerment Matter? Perceptions Of Nursing Leaders In Pakistan Through Qualitative Approach, Saleema A. Gulzar, Rozina Karmaliani Professor, Kausar S. Khan Ms, Rubina Barolia, Shirin Rahim, Aneeta Pasha

School of Nursing & Midwifery

Background: In a patriarchal society like Pakistan, where women are oppressed, women dominating professions like nursing is mostly seen as disempowered and requires considerable struggle to achieve its due recognition and respect.
Aim: This study aims to explore the experiences of empowerment among the nursing leaders of Pakistan. Methods: This study uses a qualitative descriptive design. Total of twelve Pakistani Nursing leaders were interviewed using semi-structured interview guideline to explore their experiences of empowerment.
Results: The study findings revealed five major categories which include: status of a nurse, nursing profession, power relationships, value-belief system, and leadership and management.
Conclusions: Nurses’ …

Shining A Light On Nursing Art In Pakistan, Shirin Rahim, Rafat Jan Ruknuddin, Kathryn L. Gramling

School of Nursing & Midwifery

Nursing is considered both science and art. Artful nursing has been essential for holistic nursing practice since the time of Nightingale, but it is getting neglected and has been lately limited to nursing literature (Gramling, 2004). This qualitative study seeks to gain an understanding of the perceptions of active nurses in Pakistan about nursing art and yields four major themes: artful nursing is embedded in humane responsiveness, artful nursing has healing power, artful nursing is a satisfying experience, and artful nursing is invisible in nursing practice. Study participants valued nursing art, and their perceptions illuminate Watson's Theory of Human Caring …

“Let’S Work: Involving Nursing Students In The Care Of Elderly People At Nursing Home”, Mehtab Qutbuddin Jaffer, Shanaz Hussein Cassum

School of Nursing & Midwifery

Working in nursing homes is the most challenging task for a nursing staff, but at the same time it can be a spirit jarring experience for young nursing students. From the perspective of nursing students, often students find it difficult to deal with elderly people living in the nursing home. They feel stressed, depressed, and insecure when asked to communicate with elderly people. At the Aga Khan University School of Nursing and Midwifery (AKU-SONAM), baccalaureate nursing students chose an elective course on care of elderly clients, where theory is offered in a blended form and clinical experience is provided by …

Important Steps To Maintain The Privacy Of Patients In The Hospital, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

Women are considered as vulnerable groups in our society in spite of their defined women rights by various laws. This shows that unfortunately these laws are not implemented practically in the real life. Society is shaped by the individuals and everyone should be responsible for advocating their own rights as well as the right of others especially of the vulnerable groups within the population.

Analysis Of The Health Care System Of Pakistan: Lessons Learnt And Way Forward., Zohra Kurji, Zahra Shaheen Premani, Yasmin Mithani

School of Nursing & Midwifery

BACKGROUND:

Pakistani health care system is in progress and since last year, Pakistan has tried to make much improvement in its health care delivery system and has brought out many reforms.

METHODS:

A systematic search of national and international literature was looked from peerreviewed databases form MEDLINE, CINAHL, and PubMed.

RESULTS:

There is little strength in health care delivery system in Pakistan like making health policies, participating in Millennium Development Goals program, initiating vertical programs and introducing Public Private Partnership, improving human resource development and infrastructure by making Basic Health Unit and Rural Health Centres. However, these all programs are …

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

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

School of Nursing & Midwifery

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 …

A Pilot Study Of A 6-Week Parenting Program For Mothers Of Pre-School Children Attending Family Health Centers In Karachi, Pakistan., Yasmeen Khowaja, Rozina Karmaliani Professor, Shela A. Hirani, Asif Raza Khowaja, Ghazala Rafique, Judith Mcfarlane

School of Nursing & Midwifery

BACKGROUND:

Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-schoolchildren attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan.

METHODS:

A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 …

An Ethnographic Investigation Of The Maternity Healthcare Experience Of Immigrants In Rural And Urban Alberta, Canada., Gina M. Higginbottom, Jalal Safipour, Sophie Yohani, Beverly O’Brien, Zubia Mumtaz, Patricia Paton, Yvonne Chiu, Rubina Barolia

School of Nursing & Midwifery

BACKGROUND:

Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada.

METHODS:

The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over …

Integration Of Health Promotion Into Nursing Practice: A Case Study In Pakistan., Muneerah Vastani, Rozina Karmaliani Professor, Pammla M. Petrucka

School of Nursing & Midwifery

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources; focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content …

Experiences Of Adopting Blended Pedagogies In Health Assessment Course In Post Rn Baccalaureate Program Of Nursing In Karachi, Pakistan, Shanaz Hussein Cassum, Saleema Allana, Jacqueline Maria Dias

School of Nursing & Midwifery

Purpose: There is little known about whether faculty and students in a resource constricted context experience a change in learning due to the adoption of blended learning (BL) pedagogies in a lab based course. The study aimed to understand the experiences of faculty and students’ related to the adoption of BL pedagogies in health assessment course.
Design: An action research design was used in this study to integrate planning, action and research in the setting where the change is required. The study sample consisted of year 1 Post RN BScN students enrolled at the Aga Khan University School of Nursing …

Low Self-Esteem Leads To Depression Among Elderly: Case Study Of Nursing Home, Savera Aziz Ali, Nadir Suhail, Sumera Aziz Ali

School of Nursing & Midwifery

Background: Self-esteem is defined as “how we value our self”; it affects our trust and relationships in every part of life. Person with low self-esteem may feel powerless and incompetent about himself/herself. Moreover, low self-esteem operates as a risk factor for depression, which is most common disorder among elderly people both in developed and developing countries, causing multiple behavioral changes as well as may increase the chances of depression and suicide among the elderly people. Objective: The objective of this case study was to understand the problems faced by elderly people in the nursing home and to relate the self-esteem …

Conflict Between Paternalism And Autonomy., Amber Hussain Sayani

School of Nursing & Midwifery

In the past, paternalism played an important role in making decisions at the end of life. However, in the modern era its significance has become unpopular as it require physicians to decide what is good or bad for the patient without considering patients wish and interest. This commentary article is based on a case study of a woman whose life was lost due to complications of pregnancy. The paper critically reviews this case study, and attempts to provide a reasonable and systematic framework to make sound decisions in similar cases.

Review And Analysis Of Quality Healthcare System Enhancement In Developing Countries., Zohra Kurji, Zahra Zahra Shaheen Premani Shaheen, Yasmin Mithani

School of Nursing & Midwifery

Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure quality. All frameworks give some levels in which quality could be assessed. Therefore, multiple frameworks should be used for measuring quality based on the situation and environment. Measuring quality is very important for primary healthcare programme, especially for developing countries because if we will not do quality assessment, our resources will not be utilised effectively and people may divert …

Are We Empowered? A Qualitative Approach To Unfold The Experiences Of Female Nurses In Pakistan, Saleema A. Gulzar, Rozina Karmaliani, Nasreen Lalani, Qurratulain Nasiruddin

School of Nursing & Midwifery

The disparity of men and women in certain societies, such as Pakistan, is a growing concern. The disparity, unchanging mind-set, and definitions rooted in traditions do not free individuals from the socially bound gender identities. In such circumstances, educational institutions can become a way of transforming social structures. Considering female nurses in Pakistan as a case study, this paper explores the notion of “empowerment” and the factors responsible for empowerment or disempowerment of female nurses. The study also evaluates the role of a leading nursing institution in Pakistan namely the Aga Khan University- School of Nursing and Midwifery (AKUSONAM) in …

Immigrant Women's Experiences Of Maternity-Care Services In Canada: A Systematic Review Using A Narrative Synthesis, Gina M A. Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

School of Nursing & Midwifery

Background: Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. …

Polio - An Endemic Disease In Pakistan: Literature Review, Savera Aziz Ali, Nadir Suhail, Hunaina Hadi, Mohsina Hussain, Marium Manji, Jaweria Bano, Abdul Salam, Sajida Naseer, Sumera Aziz Ali

School of Nursing & Midwifery

Poliomyelitis is a highly contagious and incurable disease, which mainly affects children under five years of age leading to irreversible paralysis and possibly death. For decades, both private and government organizations have been putting efforts through their partnership to eradicate polio completely from the different parts of the globe and as a result of those efforts there are left only three countries which are currently polio endemic. Since Pakistan is one of those three countries which still remain polio endemic along with Afghanistan and Nigeria, it is significant to address this issue and work on the preventive measures to control …

The Patterns Of Health Seeking Behavior Among Patients With Hepatitis C In Karachi, Pakistan, Shahina Sabz Ali Pirani, Tazeen S. Ali, Saleema Allana, Faisal Wasim Ismail

School of Nursing & Midwifery

Background: The study aimed to assess the patterns of health seeking behavior and the level satisfaction with the health care providers among hepatitis C patients in Karachi, Pakistan.
Methodology: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients, who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan, between March and May 2013.
Results: The patterns of health seeking behavior showed that a majority of the study participants approached a medical doctor (n=359), followed by spiritual healers (n=103), and a few participants approached traditional healers (n=38) and homeopaths (n=11). The pattern …

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

School of Nursing & Midwifery

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) …

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …