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JULY – DECEMBER 2002 VOL-3, NO.2 CLINICAL SUPERVISION * Ilavarasi Jesudoss R.N., R.M., M.Sc. (N) ABSTRACT In professional education programs, the theoretical component of a course is often the basis for skill development. These skills are then acquired through practicum and field experience. In nursing this practicum is referred to as clinical experience and is recognized as central to nursing education (Benor, 1997). The acquisition of new attitudes, concepts and roles cause tension and anxiety. This change requires clinical experience, with a clinical supervisor to assist in the assessment of progress and to provide guidance to the students in understanding new behaviors. The role of a clinical instructor and specific strategies for effective clinical supervision are discussed in this article. KANGAROO CARE * Janet Jones, R.N., R.M., M.Sc. (N) ABSTRACT Kangaroo care is a method of holding an infant with skin to skin contact, prone and up right on the chest of the parent. This method was described as a human incubator for low birth weight and preterm babies. Kangaroo care is becoming very popular throughout the world. Kangaroo care method of holding an infant was first initiated in Bogota., Columbia by two neonatologists Dr. Edger Rey and Dr. Hector Martinez in 1983 (Gale & Vanderbeg, 1998). They developed this method to decrease the morbidity and mortality rate among their neonates, which occurred mainly due to infections and lack of equipment. Kangaroo care or skin to skin holding is an intervention that benefits both infants and mothers and has been used successfully in Neonatal ICU. Infants benefit with increased weight gain, earlier feeding and reduced hospital stay and parents benefit from the increased closeness with the infant and feeling of “being able to do something”. Many studies support that Kangaroo care is a safer intervention which helps in maintaining physiological and behavioural state of small babies and it allows the parents to participate in their baby’s care in the neonatal care units. BONE MARROW TRANSPLANTATION FOR * Alok Srivastava M.D., F.R.A.C.P., F.R.C.P.A. ABSTRACT Beta Thalassaemia is a significant public health problem in many parts of India. The only curative treatment for beta thalassaemia major that is currently available is alloveneic bone marrow transplantation (BMT). It is therefore important that the medical community and the affected people be aware of this option to treatment. BMT is a complicated and expensive treatment. This article describes the principle of BMT for thalassaemia major, its procedure, possible complications and outcome. It also mentions the efforts being made at CMC, Vellore for further improving the results of BMT in this condition. MULTIPLE ROLES OF WOMEN AND THE MANAGEMENT OF BREAST-FEEDING * Vathsala Sadan, R.N., R.M., M.Sc (N) ABSTRACT Reproductive and productive periods coincide in a woman’s life cycle, making it convenient from the standpoint of health and nutrition for the mother, child care and the economy of the family. The triple burdens of women are house keeping, child care and economic activity. The objectives of this study were to identify the constraints women face in combining work with breast-feeding, to understand the strategies they adopt to overcome the constraints and to determine the support services available. One hundred (100) mothers of children under one year of age were included in the study. Of which 60 respondents were from the rural and 40 from the urban areas of the College of Nursing Community Health Programme area, Vellore. Interview was used for data collection. The study revealed that no longer can breast-feeding be thought simply as an issue concerning the mother and the child. It has to be seen as a multi faceted social issue, which needs to be addressed by the family, society, employer and government to create appropriate support structures for childcare. The description of various social, economic, domestic and psychological constraints to sustained breast-feeding draws attention to the need for supportive policies, actions and strategies which can remove these constraints and empower women to breast feed. EFFICACY OF CONTINUOUS ANALGESIA * Sajila David R.N., R.M., M.Sc. (N) ABSTRACT An experimental study was carried out in the general surgical wards of ChristianMedicalCollege and Hospital, Vellore to compare the efficacy of postoperative pain relief measures and patient satisfaction with continuous analgesia versus intermittent analgesia. A sample of 50 patients were chosen and randomly allocated into study group and control group. The study group received continuous analgesia (epidural or patient controlled analgesia (PCA)) whereas control group received intermittent analgesia (intramuscular narcotic). An observation checklist was utilized for a period of 48 hours to assess pain relief, sedation, nausea and vomiting. At the end of 48 hours, pain perception was assessed using visual analog scale (VAS) and patient satisfaction was assessed using a four point Likert scale. The comparison of the efficacy of the postoperative pain relief measures revealed that the study group had better pain relief, sedation and more satisfaction compared to the control group (intermittent analgesia). Towards the end of the study, nurses’ opinion on the pain relief measures was assessed using a questionnaire. The majority of the nurses also preferred continuous analgesia as a pain relief method for their patients. CONTINUING EDUCATION SERIES – NO:III * Jayarani Premkumar, R.N., R.M., M.Sc (N) This article is the continuation of the previous CE on Traumatic Brain Injury, Pathophysiology (part I) and Assessment (part II). In this article, the details of Medical and Nursing Management of TBI are discussed. ABSTRACT Traumatic brain injury continues to pose a serious health care challenge throughout the world. Trauma is the leading cause of death in individuals under 45 years of age. The essential principles of care include continuous ongoing assessment, immediate care to preserve life and prevention of complications. Nursing personnel need to be quick, alert and goal oriented to maintain and preserve the brain function of the injured. |