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JAN – JUN 2010 VOL-11, NO.1 PROBLEM BASED LEARNING: AN INNOVATIVE METHOD FOR CLINICAL TEACHING * Asha Solomon, M.Sc (N) ABSTRACT Problem Based Learning (PBL) is an instructional method where students use "cues" from the problem case or scenario to define their own learning objectives. Subsequently they do independent, self directed study before returning to the group to discuss and refine their acquired knowledge. The characteristics and benefits of PBL from relevant literature are discussed in this article. The authors also share their experience of introducing PBL as a new modality in clinical instruction for nursing students. ASSESSMENT OF CHRONIC WOUNDS: A CHALLENGE FOR NURSES * Reena George, M.Sc (N) ABSTRACT The key to successful wound management is careful and accurate assessment of the wound. This necessitates the need to develop a tool that is able to consistently and quantitatively measure and document the progress of the wound. A good tool should be accurate, easy to use and sensitive to change. A chronic wound assessment tool has been prepared based on PUSH (Pressure Ulcer Scale for Healing) scale and represents an excellent starting point to validate the healing of chronic wounds, fulfilling the need for a simple, valid, reliable and practical tool for monitoring the process of healing. Nurses can develop knowledge and competence in the assessment and care of chronic wounds that would help them involve actively and independently in the management of patients with chronic wounds. NURSES’ ROLE IN THE COMPREHENSIVE CARE OF CLIENTS WITH BRAIN TUMOUR: A LITERATURE REVIEW * Varghese Jessa, B.Sc (N) ABSTRACT Persons with brain tumour experience their disease in a larger way than their symptoms indicate, since this diagnosis not only affects the cortical processes but also has substantial social impact. The purpose of this literature review was to describe the role of a nurse in the comprehensive care of clients with brain tumour throughout the illness trajectory. This descriptive literature review is based on 16 scientific studies published from 1998 to 2006, obtained through systematic search in scientific databases. The results present the strategic position of the nurse in caring for the clients with brain tumour and supporting the informal caregiver throughout the illness trajectory. The nurses' role begins with the client's first contact with the health services at the time of diagnosis, then all along laboratory investigations, treatment process, consultations, hospitalizations and most importantly while discussing the end-of-life decisions. The supreme role of the nurse is as the "source of information", all through this spectrum of disease. The care becomes comprehensive when equal emphasis is placed on supporting the informal caregiver through anticipating their needs for information and facilitating the grieving process along the crisis of the terminal phase. The nurses share the unique responsibility of empowering the client with brain tumour and his/her family to tackle the illness, together with other health professionals. The nurse is also the easily approachable person for the client through all facets of his/her disease. She also has the special opportunity to intervene and assist the family member to become an efficient and healthy caregiver. RESEARCH PROCESS: AN OVERVIEW * Premila Lee, M.Sc (N)., Ph.D ABSTRACT Evidence provides the basis for effective and efficient nursing practice. Research is a key element in evidence based practice which is a process and has several distinct phases namely formulating and defining the research problem, reviewing the literature, selecting a theoretical framework, determining an appropriate design, defining a sampling strategy, collecting data, analyzing data and communicating the findings. These processes may be in sequence or may overlap. This article intends to help the reader to gain a comprehensive view of the various phases of quantitative research process. MANAGEMENT OF PATIENTS WITH MULTI DRUG RESISTANCE TUBERCULOSIS * Jayarani Premkumar, M.Sc (N)., Ph.D ABSTRACT Tuberculosis (TB) is the second greatest contributor among infectious diseases to adult mortality, being responsible for approximately two million deaths a year worldwide. More than 490,000 cases of Multi Drug Resistant Tuberculosis (MDR-TB) emerge every year as a result of under investments in basic activities to control TB, poor management of anti-TB drugs and transmission of drug-resistant strains. The people infected with this disease readily spread it to others. Therefore, it is of utmost importance to stop the development and spreading of MDR-TB. In 2006, extensively drug-resistant TB (XDR-TB), a sub type of MDR-TB was reported in all the regions of the world and was rapidly classified by WHO as a serious emerging threat to global public health especially, in countries with a high prevalence of Human Immuno deficiency Virus (HIV). Nursing professionals have more responsibilities in the treatment of patients with tuberculosis. This CNE article reviews the pathophysiology, diagnosis and management of tuberculosis and focuses on the care of patients with MDR-TB. EFFECTIVENESS OF INFRARED THERAPY UPON EPISIOTOMY PAIN AND WOUND HEALING IN POSTNATAL MOTHERS * Venkadalakshmi V, M.Sc (N) ABSTRACT An experimental research study with pre-test, post-test design was conducted at selected Hospitals in Kovilpatti, Tamil Nadu. The sample size was 60, chosen by systematic randomization and divided into control group and experimental group of 30 each. The investigator used a demographic variable proforma, a pain intensity scale to measure episiotomy pain, REEDA scale to assess the wound healing and a questionnaire to assess the subjects' knowledge regarding episiotomy care. The investigator assessed the knowledge of the subjects regarding episiotomy care in both the groups. The subjects in the control group used the existing methods of episiotomy care such as perineal wash and sitz bath whereas, the subjects of the experimental group were provided with the infrared therapy for 10 minutes. Episiotomy pain was measured prior to, immediately after and three hours after the application of infrared therapy in the morning and evening for three consecutive days. The REEDA scale was used to assess the episiotomy wound healing every morning for three consecutive days. The mean episiotomy pain score of the control group participants was high on all three days in comparison with the experimental group. The difference was found to be statistically significant (p<0.001). It was found that 10% of the participants in the control group developed mild infection whereas none of the participants in the experimental group developed any infection at the episiotomy site on the third day of observation. ROLE OF INEXPERIENCED AND EXPERIENCED FATHERS IN INFANT REARING * Beryl Mohanraj, M.Sc (N) ABSTRACT Historically the father's role is to provide and protect the family. In today's modern and fast changing society, families are becoming nuclear, mothers are professionals and have jobs. Hence, infant rearing is not only the mother's responsibility but also the father's. Changes from more traditional to contemporary family structures and roles in the family units also demand fathers' participation in the care of an infant. A comparative study to determine the role of inexperienced and experienced fathers in infant rearing in the villages of College of Nursing Community Health programme, in CMC, Vellore was done using convenience sampling technique. The study findings revealed that there was no significant statistical difference between the inexperienced and experienced fathers in their overall participation in infant rearing. Nurses working in maternal, child health and community areas have the responsibility to include and assist fathers in the caring skills for their newborns. |