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JAN – JUN 2017 VOL-18, NO.1

Curriculum Evaluation: Using the Context, Input, Process and Product (CIPP) Model for Decision Making

*Manoranjini Vishnupriyan, M.Sc (N)., MBA (HM)
* Nursing Tutor, Himalayan College of Nursing, Dehradun

ABSTRACT

Evaluation is a systematic investigation of the value of a program. More specifically an evaluation is a process of delineating, obtaining, reporting, and applying descriptive and judgmental information about some object's merit, worth, probity, and significance. A sound evaluation model provides a link to evaluation theory, a structure for planning evaluations, a framework for collaboration, a common evaluation language, a procedural guide, and standards for judging evaluation. This model tends to observe the obtained result than pretending to get the result as per the preset goal or the expected outcome of a curriculum. One evaluation model that is used widely to evaluate a curriculum or programme is the Context, Input, Process, and Product (CIPP) model. This article attempts to describe the CIPP model and explains the application of the model in a research project.

Keywords: evaluation, CIPP model, framework

REFERENCES

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Keating, S. B. (Ed.). (2014). Curriculum development and evaluation in nursing. Newyork: Springer Publishing Company.

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Stake, R. (1967). The Countenance of educational evaluation in teachers college. Retrieved from http://www. tcrecord.org/ library

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Stufflebeam, D. L. (1971). An EEPA interview with Daniel L. Stufflebeam. Educational Evaluation and Policy Analysis, 2(4), 85-90.

Stufflebeam, D. L. (1983). The CIPP model for program evaluation. In Evaluation models . Dordrecht : Springer.

Stufflebeam, D. L., Madaus, G. F., & Kellaghan, T. (Eds.). (2000). Evaluation models: Viewpoints on educational and human services evaluation. Boston: Springer Science & Business Media.

Stufflebeam, D. L. (2003a). The CIPP model for evaluation. The International Handbook of Educational Evaluation, 9, 31-62.

Stufflebeam, D.L., (2003b). The CIPP model for evaluation. Paper presented at the Annual Conference of the Oregon Program Evaluators Network, Portland, Oregon.

Stufflebeam D.L. (2007). CIPP evaluation model checklist : A tool for applying the CIPP Model to assess long-term enterprises. Retrieved from https: //www .wmich. edu/ sites/ default/files /attachments /u350/2014/ cippchecklist_mar07.pdf

Tyler, R. (1969). Basic principle of curriculum and instruction. Chicago & London: The University of Chicago press.

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Health Care Collaboration Model: A Synchronized Relationship

*Ratna Prakash, M.Sc (N)., Ph.D (N)
* Principal, Pal College of Nursing & Medical Sciences, Nainital

ABSTRACT

In the scenario of nursing students' clinical learning, clinical supervisor is the key person to orchestrate health care collaboration. With this thought, a pilot project was initiated to examine the feasibility of a 'Health Care Collaboration Model', connecting nursing education, research, and service. Modified action research approach and a descriptive exploratory survey design were adopted to discover the perceptual worlds of the major actors, such as, nursing teachers, nursing students and clinical nurses of a 250 bedded multi-specialty health care institution of Uttarakhand, regarding clinical supervision, clinical competency and holistic health care in the perspective of a 'Health Care Collaboration Model'. The views of all categories of health care professionals about the model were obtained so as to get a total picture of the perception of the health team about the model. Focus-group discussion and brain storming methods were used to initiate the study process. A questionnaire, an observation checklist, rating scale and an opinionnaire were used to collect data for a period of 29 days. The result showed the differences in perceptions of nursing teachers, nursing students and clinical nurses regarding clinical supervision, clinical competency, and holistic health care, in the perspective of a 'Health Care Collaboration Model'. Performance of the nursing personnel in all three aspects was below mean, showing inadequate effectiveness of care (according to the maxims of 'Health Care Collaboration Model'). Quantified views of health care personnel about the merits and demerits of the 'Health Care Collaboration Model' revealed that nursing students, teachers, and patients had more positive thinking about the model than other personnel working in the clinical areas. The project report has acknowledged the limitations which would have affected the outcome. Yet the 'gap' between nursing education and nursing practice was overt throughout the study. It is suggested that all health professionals and society should come together through a synchronized relationship to make this model a reality, as this can be one of the best solution to control the alarming situation of general health status of our people and improve holism in providing care.

Keywords: health care collaboration model, modified action research, holistic care, clinical nurses, clinical supervisor, nursing students

REFERENCES

Baggs, J. G., Schmitt, M. H., Mushlin, A. I., Mitchell, P. H., Eldredge, D. H., Oakes, D., & Hutson, A. D. (1999). Association between nurse-physician collaboration and patient outcomes in three intensive care units. Critical Care Medicine, 27(9), 1991-1998.

Beal. J. (2012). Academic-service partnerships in nursing: An integrative review. Nursing Research and Practice. Retrieved from https:// www.hindawi.com/ journals /nrp/2012/501564/

Dossey, B. M., & Guzzetta, C. E. (2005). Holistic nursing: A handbook for practice . Boston, MA: Jones and Bartlett.

Drury, C. & Hunter, J. (2016). The Hole in Holistic Patient Care. Open Journal of Nursing, 6, 776-792. doi.org/10.4236/ojn.2016.69078

Henneman, E. A., Lee, J. L., & Cohen, J. I. (1995). Collaboration: A concept analysis. Journal of Advanced Nursing, 21(1), 103-109. doi.org/10.1155/2012/501564

Polit, D. F., & Beck, C. T. (2016). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia : Lippincott Williams & Wilkins.

Smith, B. J. (2015). The case for international collaboration in academic library management, human resources and staff development. International Federation of Library Association and Institutions Journal, 41(2), 140-152.

Thomas, S. A., & Hargett, T. (1999). Mental health care: A collaborative, holistic approach. Holistic Nursing Practice, 13(2), 78-85.

Thomson, A. M., Perry, J. L., & Miller, T. K. (2007). Conceptualizing and measuring collaboration. Journal of Public Administration Research and Theory, 19(1), 23-56.

Osteogenesis Imperfecta: A Case Report

*Priscilla R. Sam, M.Sc (N)
* Professor, College of Nursing, CMC, Vellore

ABSTRACT

Osteogenesis Imperfecta is a commonly inherited connective tissue disorder caused by mutations of COLIA 1 and 2, Cartilage Associated Protein (CRTAP) and also Leucine Proline Enriched Proteoglycan 1 genes. It is found to primarily affect the bones and increase bone fragility due to decreased bone mass and results in short stature. It is also found to be a systemic disorder as it results in dentinogenesis, hearing loss, restrictive pulmonary disease, scoliosis, and ocular complications. It is classified based on clinical, radiological, and genetic features. There are both conservative and surgical options available for its management. A team approach is needed to take care of these children as they have recurrent fractures, bowing deformities, and also systemic complications. This article will help one to know of the kind of expertise that is needed to look after the needs of these children.

Keywords: Osteogenesis Imperfecta, gene mutations, increased bone fragility, management

REFERENCES

Baldridge, D., Lennington, J., Weis, M., Homan, E. P., Jiang, M. M., Munivez, E., & Krakow, D. (2010). Generalized connective tissue disease in Crtap-/-mouse. PloS one, 5(5), e10560.

Barnes, A. M., Carter, E. M., Cabral, W. A., Weis, M., Chang, W., Makareeva, E., ...& Marini, J. C. (2010). Lack of cyclophilin B in Osteogenesis Imperfecta with normal collagen folding. New England Journal of Medicine, 362(6), 521-528.

Brusin, J. H. (2008). Osteogenesis Imperfecta. Radiologic Technology, 79(6), 535-548.

Cho, T. J., Kim, J. B., Lee, J. W., Lee, K., Park, M. S., Yoo, W. J., ... & Choi, I. H. (2011). Fracture in long bones stabilised by telescopic intramedullary rods in patients with Osteogenesis Imperfecta. Journal of Bone Joint and Surgery British Volume, 93(5), 634-638.

Forlino, A., Cabral, W. A., Barnes, A. M., & Marini, J. C. (2011). New perspectives on osteogenesis imperfecta. Nature Reviews Endocrinology, 7(9), 540-557.

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Hockenberry, M. J., & Wilson, D. (2001).Wong's Essentials of Pediatric Nursing. USA: Mosby publishers.

Homan, E. P., Rauch, F., Grafe, I., Lietman, C., Doll, J. A., Dawson, B., ... & White, L. (2011). Mutations in SERPINF1 cause Osteogenesis Imperfecta type VI. Journal of Bone and Mineral Research, 26(12), 2798- 2803.

Maher, A. B., Salmond, S. W., & Pellino, T. A. (2002). Orthopaedic nursing. Philadelphia: Saunders.

Marini, J. (2010). Osteogenesis Imperfecta. In F. Singer (Ed.), Diseases of bone and calcium metabolism. Retrieved from http://www. endotext.org/ chapter/ osteogenesis -imperfecta/

Martinez-Soto, T., Pacaud, D., Stephure, D., Trussell, R., & Huang, C. (2011). Treatment of symptomatic osteoporosis in children: A comparison of two Pamidronate dosage regimens. Journal of Pediatric Endocrinology and Metabolism, 24(5-6), 271-274.

National Library of Medicine. (2011). Osteogenesis Imperfecta . Retrieved May 7, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/0015 73.htm

Sillence, D. O., Senn, A., & Danks, D. M. (1979). Genetic heterogeneity in Osteogenesis Imperfecta. Journal of Medical Genetics, 16(2), 101-116.

Smith, R., Francis, M. J., & Houghton, G. R. (1983). The brittle bone syndrome: Osteogenesis Imperfecta. London: Butterworths.

Wilson, D., & Hockenberry, M. J. (2014). Wong's clinical manual of paediatric nursing-e-book. USA: Elsevier Health Sciences.

Acute Respiratory Distress Syndrome: A Case Presentation

*Angel Rajakumari, M.Sc (N)
* Junior Lecturer, College of Nursing, CMC, Vellore

ABSTRACT

Acute Respiratory Distress Syndrome (ARDS) is a major condition in an Intensive Care Unit. It was previously known as non-cardiogenic pulmonary edema. It is caused by various conditions due to damage to the lung, but the main reason is sepsis. It damages the alveolar capillary membrane that leads to interstitial and alveolar edema, diffuse alveolar damage, refractory hypoxemia, and ventilation perfusion mismatch. The common clinical manifestation is dyspnea with diffuse infiltration in chest X-ray. The management of ARDS includes setting low tidal volume, high Positive End Expiratory Pressure (PEEP) and low plateau pressure. Prone positioning will improve perfusion to the patient and thereby increase PaO2/FiO2 ratio. The recent trend of High Frequency Oscillation Ventilation (HFOV) is used to manage ARDS.

Keywords: Acute Respiratory Distress Syndrome, Acute Lung Injury, dyspnea, ventilation

REFERENCES

Bellingan, G. J. (2002). The pulmonary physician in critical care 6: The pathogenesis of ALI/ARDS. Thorax, 57(6), 540-546.

Bhatia, M., & Moochhala, S. (2004). Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. The Journal of Pathology, 202(2), 145-156.

Cordingley, J. J., & Keogh, B. F. (2002). The pulmonary physician in critical care. 8: Ventilatory management of ALI/ARDS. Thorax, 57(8), 729-734.

Derdak, S., Mehta, S., Stewart, T. E., Smith, T., Rogers, M., Buchman, T. G., ... & Multicenter Oscillatory Ventilation for Acute Respiratory Distress Syndrome Trial (MOAT) Study Investigators. (2002). High- frequency oscillatory ventilation for acute respiratory distress syndrome in adults: A randomized, controlled trial. American Journal of Respiratory and Critical Care Medicine, 166(6), 801-808. doi.org/ 10.1164 /rccm.2108052

Force, A. D. T. (2012). Acute respiratory distress syndrome. Rubenfeld, G. D., Caldwell, E., Peabody, E., Weaver, J., Martin, D.

P., Neff, M., ... & Hudson, L. D. (2005). Incidence and outcomes of acute lung injury. New England Journal of Medicine, 353(16), 1685-1693.

Singh, G., Gladdy, G., Chandy, T. T., & Sen, N. (2014). Incidence and outcome of acute lung injury and acute respiratory distress syndrome in the surgical intensive care unit. Indian Journal of Critical Care Medicine: Jama, 307(23), 2526-2533. jama.2012.5669doi.org /10.1001/Peer-Reviewed, Official Publication of Indian Society Of Critical Care Medicine, 18(10), 659

Goss, C. H., Brower, R. G., Hudson, L. D., & Rubenfeld, G. D. (2003). Incidence of acute lung injury in the United States. Critical Care Medicine, 31(6), 1607-1611.

Harman, M. E. (2017). Acute Respiratory Distress Syndrome: Background, pathophysiology, etiology. Medscape . Retrieved from http://emedicine. medscape.com/article/165139-overview#showall

Helwick, C. (2009). P/F Ratio may be a marker of potential intraoperative Ventilator-Induced Lung Injury. Retrieved from http://en. citizendium.or g/wiki/P:F_ratio

John, G., Subramani, K., Peter, J.V., Pichamuthu, K., & Chacko, B. (2011). Essentials of critical care. Vellore: Chummy Printers.

Luhr, O. R., Antonsen, K., Karlsson, M., Aardal, S., Thorsteinsson, A., Frostell, C. G., ... & ARF Study Group. (1999). Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. American Journal of Respiratory and Critical Care Medicine, 159(6), 1849-1861.

Morton, P. G., Fontaine, D. K., & Hudak, C. M. (2009). Critical Care Nursing. A Holistic approach. China: Lippincott Williams & Wilkins.

Pneumatikos, I., & Papaioannou, V. E. (2012). The new Berlin definition: What is, finally, the ARDS. Pneumon, 25(4), 365-368.Sud, S., Sud, M., Friedrich, J. O., Meade, M. O., Ferguson, N.D., Wunsch, H., & Adhikari, N. K. (2010). High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): Systematic review and meta-analysis. British Medical Journal, 340, c2327.

The Acute Respiratory Distress Syndrome Network. (2000). Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New England Journal of Medicine, 342(18), 1301-1308. doi.org/10.1056/NEJM200005043421801

Tomashefski Jr, J. F. (1990). Pulmonary pathology of the adult respiratory distress syndrome. Clinics in Chest Medicine, 11(4), 593-619.

Urden, D.L., Stacy, M.K., & Lough, E.M. (2012). Critical Care Nursing: Diagnosis and Management. Missouri: Elsevier Publications.

Villar, J., Blanco, J., Añón, J. M., Santos-Bouza, A., Blanch, L., Ambrós, A., ... & Fernández, R. L. (2011). The ALIEN study: Incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Medicine, 37(12),1932-1941.

Walkey, A. J., Summer, R., Ho, V., & Alkana, P. (2012). Acute respiratory distress syndrome: Epidemiology and management approaches. Clinical Epidemiology, 4,159. doi.org/10.2147/CLEP.S28800

Relationship between Sleep Quality and Glycaemic Control among Subjects with Type 2 Diabetes Mellitus

*Abijah Princy, M.Sc (N)
** Valliammal Babu, M.Sc (N)
*** Sheela Durai, M.Sc (N)
**** Hesarghatta S. Asha, DNB (Gen. Med.)., DNB (Endo.)
***** Antonisami Belavendra, Ph.D., F.R.S.S., F.S.M.S

*Junior Lecturer, College of Nursing, CMC, Vellore
** Retd. Professor, College of Nursing, CMC, Vellore
***Professor, College of Nursing, CMC, Vellore
****Associate Professor, Dept. of Endocrinology, CMC, Vellore
*****Professor, Biostatistics, CMC, Vellore

ABSTRACT

Sleep disturbance has evolved as an unrecognised health issue among the Diabetic patients. Information on sleep quality in Type 2 Diabetes in relation to the glycaemic control is limited and is rarely explored. This study was designed to assess the relationship between sleep quality and glycaemic control among subjects with Type 2 Diabetes Mellitus attending the Endocrinology Outpatient Department of a tertiary care centre in South India. A non-experimental descriptive design was undertaken. A total of 500 Type 2 Diabetic subjects (male- 242, female-258) aged between 20-70 years were selected based on total enumeration sampling technique. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) and glycaemic control was estimated using HbA1c levels obtained within the past six months. Descriptive and inferential non parametric statistics such as frequency distributions, median, range, Spearman rank's correlation, Mann Whitney U test, Kruskal Wallis test, and Chi square tests were used to analyse the data. Among the subjects 63.6% had poor sleep quality (PSQI >5) and 74.6% of them had poor glycaemic control (HbA1c >7%). The median HbA1c of poor quality sleepers was 8.25% in comparison with good quality sleepers (Median HbA1c-7.80 %). Low positive correlation existed between sleep quality and glycemic control (rs= .09, p=.036). Majority of Type 2 Diabetics have poor sleep quality and poor glycaemic control. Progressive increase in HbA1c existed as the sleep quality worsened. This warrants further exploration into the details of the relationship between sleep quality and glycaemic control.

Keywords: sleep quality, glycaemic control, type 2 diabetes mellitus

REFERENCES

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Cumberbatch, C. G., Younger, N. O., Ferguson, T. S., McFarlane, S. R., Francis, D. K., Wilks, R. J., & Tulloch- Reid, M. K. (2011). Reported hours of sleep, diabetes prevalence and glucose control in Jamaican adults: Analysis from the Jamaica lifestyle survey 2007-2008. International Journal of Endocrinology, Retrieved from http://www.hindavi.com/journals/ije/2011/716214

Goudswaard, A. N., Stolk, R. P., Zuithoff, P., & Rutten, G. E.H. M. (2004). Patient characteristics do not predict poor glycaemic control in type 2 diabetes subjects treated in primary care. European Journal of Epidemiology, 19 (6),541 545. doi:10.1023/B:EJEP.0000032351.42772.e7

Gozashti, M. H., Eslami, N., Radfar, M. H., & Pakmanesh, H. (2016). Sleep pattern, duration and quality in relation with glycemic control in people with type 2 diabetes mellitus. Iranian Journal of Medical Sciences, 41(6), 531.

Jin, Q.-H., Chen, H.-H., Yu, H.-L., & Li, T.-L. (2012). The relationship between sleep quality and glucose level, diabetic complications in elderly type 2 diabetes mellitus. Chinese Journal of Internal Medicine, 51(5), 357361.

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Knutson, K. L., Ryden, A. M., Mander, B. A., & Van Cauter, E. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Archives of Internal Medicine, 166(16), 17681774. doi:10.1001/ archinte.166.16.1768

Knutson, K. L., Van Cauter, E., Zee, P., Liu, K., & Lauderdale, D. S. (2011). Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes. Diabetes care,34(5), 1171-1176.

Kohatsu, N. D., Tsai, R., Young, T., VanGilder, R., Burmeister, L. F., Stromquist, A. M., & Merchant, J. A. (2006). Sleep duration and body mass index in a rural population. Archives of Internal Medicine, 166(16), 1701-1705.

Manzar, M. D., Moiz, J. A., Zannat, W., Spence, D. W., Pandi- Perumal, S. R., BaHammam, A. S., & Hussain, M. E. (2015). Validity of the Pittsburgh Sleep Quality index in Indian University students. Oman Medical Journal,30(3),193.

Narisawa, H., Komada, Y., Miwa, T., Shikuma, J., Sakurai, M., Odawara, M., & Inoue, Y. (2017). Prevalence, symptomatic features, and factors associated with sleep disturbance/insomnia in Japanese patients with type-2 diabetes. Neuropsychiatric Disease and Treatment, 13,1873.

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Rajendran, A., Parthsarathy, S., Tamilselvan, B., Seshadri, K.G., & Shuaib, M. (2012). Prevalence and correlates of disordered sleep in Southeast Asian Indians with type 2 diabetes. Diabetes and Metabolism Journal, 36(1), 70-76. doi:10.4093/dmj.2012.36.1.70

Tsai, Y. W., Kann, N. H., Tung, T. H., Chao, Y. J., Lin, C. J., Chang, K. C., ... & Chen, J. Y. (2011). Impact of subjective sleep quality on glycemic control in type 2 diabetes mellitus. Family Practice , 29 (1), 30-35. doi:10.1093/fampra/cmr041

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Zizi, F., Pandey, A., Murrray-Bachmann, R., Vincent, M., McFarlane, S., Ogedegbe, G., & Jean-Louis, G. (2012). Race/ethnicity, sleep duration, and diabetes mellitus: Analysis of the National Health Interview Survey. The American Journal of Medicine, 125(2), 162-167.

Community - Based Intervention Package on Knowledge, Attitude and Selected Skills of Home Care among Primary Care Givers of Children with Cerebral Palsy

*Joy Priyadharishini, M.Sc (N)
** Vathsala Sadan, M.Sc (N)., Ph.D. (N)
*** Prashanth, M.D (Community Medicine)
**** Tunny Sebastian, M.Sc., Ph.D

* Junior Lecturer, College of Nursing, CMC, Vellore
**Professor, College of Nursing, CMC, Vellore
***Associate Profess, Community Medicine, CMC, Vellore
****Lecturer, Dept. of Biostatistics, CMC, Vellore

ABSTRACT

Cerebral Palsy is the third most common and major developmental disability. Global data on the need for rehabilitation in the developing countries are increasing and only few of them receive the medical rehabilitation and assistive devices they need. To combat these problems, community- based rehabilitation evolved and was found to be extremely useful in rehabilitating people with disability in the community setting. A pre-experimental one group pre-test post-test study design was used to assess the effectiveness of a Community - Based Intervention Package (CBIP) on knowledge, attitude, and selected skills of primary care givers of children with Cerebral Palsy regarding home care in Vellore City. Convenience sampling was used to select 40 study subjects who were the primary care givers of children with cerebral palsy. A structured interview guide prepared by the investigator was used to collect data for the study. The difference in the mean scores of knowledge, attitude, and selected skills of the primary care givers of children with cerebral palsy after CBIP was found to be statistically significant (p <.001). There was a positive correlation found between the skills of the primary care givers of children with Cerebral Palsy regarding home care and their knowledge and attitude after CBIP (p=.045, p = .003). This shows that the community based interventions are effective for children with Cerebral Palsy.

Keywords: : community- based intervention package, primary care givers, Cerebral Palsy, knowledge, attitude

REFERENCES

Arora, S. K., Aggarwal, A., & Mittal, H. (2014). Impact of an educational film on parental knowledge of children with cerebral palsy. International Journal of Pediatrics, 2014. Retrieved from http://dx.doi.org/10.1155/2014/573698

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2012). Pediatric primary care- E-Book. Philadelphia: Elsevier Health Sciences.

Centers for Disease Control and Prevention. (2016). Data and statistics for Cerebral Palsy. Retrieved from http://www.cdc.gov/ncbddd/cp/data.html

Freeborn, D., & Knafl, K. (2014). Growing up with cerebral palsy: Perceptions of the influence of family. Child: Care, Health and Development, 40(5), 671-679.

Gambhir, S. K., Walia, B. N. S., Singh, P. D., & Prashad, D. (1993). Maternal attitudes towards spastic cerebral palsy. Indian Pediatrics, 30, 1073-1073.

Karande, S., Patil, S., & Kulkarni, M. (2008). Impact of an educational program on parental knowledge of cerebral palsy. Indian Journal of Pediatrics,75(9), 901-906.

Lakshmi, K. N., & Saraswathi, K. N. (2012). Effectiveness of Structured Teaching Programme on Knowledge regarding Home Care Management of Children with Cerebral Palsy among Mothers in Selected Special Schools at Bangalore.Asian Journal of Nursing Education and Research, 2(4), 2.

Mohammed, S. A. E. R. (2005). Knowledge, attitude and practice of mothers of children with cerebral palsy. Retrieved from www.khartoumspace.uofk.edu

World Health Organization. (2017). Disability and rehabilitation: Community based rehabilitation. Retrieved from http://www.who.int/ disabilities/ cbr/en/

Determinants of Treatment Noncompliance among Pulmonary Tuberculosis

*Manu Bala, M.Sc (N)
** Jaspreet K. Sodhi, M.Sc (N)
*** Kapil Sharma, M.Sc (N)

*Lecturer, Ramsnehi College of Nursing, Bhilwara
**Vice Principal, Sidhu College of Nursing, Doraha
***Asst. Professor, CON, Dayanand Medical College, Ludhiana

ABSTRACT

Tuberculosis remains a major public health problem worldwide. According to WHO, one third of the world's population is infected by latent Tuberculosis. There is an alarming increase in incidence of multi drug resistant Tuberculosis patients in Ludhiana district. The main reason for this is noncompliance of patients to therapy. Qualitative study provides deeper insight into exploration of factors responsible for noncompliance. The aim of this study was to explore the determinants of treatment noncompliance among Pulmonary Tuberculosis patients registered under Revised National Tuberculosis Control Programme, Ludhiana, Punjab. Sample of thirty five patients with Pulmonary Tuberculosis with treatment noncompliance, attending DOTS clinics, under the Revised National Tuberculosis Control Programme, Ludhiana, Punjab were included by purposive sampling technique till saturation of data was obtained. The results of findings depicted six themes namely psychological effects, physical problems, psychosocial problems, role of health professionals, financial burden, and health system related factors. The study concluded that there were various determinants for treatment noncompliance. It can be recommended that the counselling session and regular follow up are needed to reduce the noncompliance and improve the quality of patient life.

Keywords: Pulmonary Tuberculosis, noncompliance, determinants, qualitative study

REFERENCES

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Gebreegziabher, S. B., Yimer, S. A., & Bjune, G. A. (2016).http:// dx.doi.org/10.1155

Mayan, J. M. (2009). Essentials of qualitative inquiry. Walnu Greek, CA: Left Coast Press.

TB India. (2012). Revised national TB control programme.Government of India. Retrieved from https: //tbcindia.gov.in/showfile.php?lid=3141

Turunen, H., Perala, M. L., & Merilainen, P. (1994).Modification of Colaizzi's phenomenological method; A study concerning quality care. Hoitotiede, 6(1), 8-15.

Data Collection Methods in Quantitative Research

* Vathsala Sadan, M.Sc. (N)., Ph.D. (N)

*Professor, College of Nursing, CMC, Vellore

ABSTRACT

The information provided by the study participants on specific area of research called the data are very important that enable accurate information on the research work done by nurse researchers. Data collection methods are used to collect data in a systematic way. The researchers choose and use various data collection methods. They are broadly classified as self -reports, observation, and biophysiologic measures. This article highlights on the sources of data and on the various data collection techniques which include interviews, questionnaires, scales, category system and check lists, rating scales, and biophysiologic measures. It also analyses the advantages and disadvantages of each of these methods. Emphasis should be given on choosing appropriate method to collect accurate information which will lead to good quality research outcomes.

Keywords: data, quantitative, interview, questionnaire, observation, biophysiologic

REFERENCES

BCreswell, J.W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Thousand Oaks, CA: Sage.

Grove, S.K., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louis: Elsevier Saunders.

Grove, S.K., Gray, J., & Burns, N. (2015). Understanding nursing research: Building an evidence based practice. Kundli: Reed Elsevier India.

Houser, J. (2011). Nursing research: Reading, using, and creating evidence.Kundli: Sanat Printers.

Murugan, M.G. (2015). A critical analysis of the techniques for data gathering in legal research. Journal of Social Sciences and Humanities, 1 (3), 266-274.

Polit, D.F., & Beck, C.T. (2015). Essentials of nursing research: Appraising evidence for nursing practice. New Delhi: Wolters Kluwer.

Polit, D.F., & Beck, C.T. (2017). Nursing research: Generating and assessing evidence for nursing. Philadelphia: Lippincott Williams & Wilkins.

Breast Cancer

* Shalini Chandran, M.Sc (N)
** Anbu S. Kumar, M.Sc (N)
*** Anandha R. Jacob, M.Sc (N)
**** Reena George, M.Sc (N)
***** Sudha Kuppuswamy, G.N.M
****** Leena Jared, P.B.B.Sc (N)
******* Suseela Rajkumar, P.B.B.Sc (N)
******** Silvia Rani, P.B.B.Sc (N)

* Reader, College of Nursing, CMC, Vellore
** Retd.Professor, College of Nursing, CMC, Vellore
***Professor, College of Nursing, CMC, Vellore
**** Professor, College of Nursing, CMC, Vellore
*****Breast Care Nurse, CMC, Vellore
****** Breast Care Nurse, CMC, Vellore
*******Charge Nurse, CMC, Vellore
********Charge Nurse, CMC, Vellore

ABSTRACT

Breast cancer is one of the most feared illnesses and a major health problem for women. Many women believe that their risk for breast cancer is greater than their risk for any other type of illness. Greater knowledge of breast cancer will lead to early detection which is associated with higher long-term survival rates. This article gives an overview about breast cancer and its management. A case report is presented and the nursing care has been discussed in detail.

Keywords: breast cancer, women, major health problem

REFERENCES

American Cancer Society. (2016). Breast cancer survivalRates. retrieved from https://www.cancer.org

American Cancer Society. (2017). Breast cancer treatment.Retrieved from https://www.cancer.org

American Joint Committee on Cancer Breast (2017).American Joint Committee on Cancer Cancer Staging Manual. New York, NY: Springer.

Angahar, L. T. (2017). An overview of breast cancerepidemiology, risk factors, pathophysiology, and cancer risks reduction. Medcrave Online Journal Biology and Medicine, 1(4).

Breast cancer Symptoms. (2018). Retrieved from http://ihealthexpertise.com/how-to-recognize-early- signs-of-breast-cancer/

Chlebowski, R.T, Anderson, G. L., Gass, M., Lane, D.S., Aragaki, A. K., Kuller, L. H.,.Prentice, R. L. (2010). Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. Journal of the American Medical Association. 304(15), 1684-92.

Dodge, D. G., & Kegel, J. L. (2006). Advances in Breast Cancer Screening and Diagnosis, The Journal of Lancaster General Hospital, 1(2), 47-51.

Gulanick, M., & Myers, J. L. (2014). Nursing care plans- diagnoses, interventions and outcomes. Philadelphia: Elsevier Mosby.

Gabriel, A,. (2016). Breast anatomy. Retrieved from https://reference.medscape.com/article/1273133- overview

Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing. New Delhi: Wolters Kluwer.

Iqbal, N., & Iqbal, N. (2014). Human Epidermal Growth Factor Receptor 2 (HER2) in cancers: Overexpression and therapeutic implications. Molecular Biology International. doi: 10.1155/2014/852748.

Katz, J. (2016). Breast cancer risk factors. Medscape. Retrieved from http:// emedicine. medscape.com /article/1945957-overview

Lahmann, P. H., Hoffmann, K., Allen, N., VanGils, C. H., Khaw, K. T., Tehard, B., et.al. (2004). Body size and breast cancer risk: Findings from the European Prospective Investigation into Cancer And nutrition (EPIC). International Journal of Cancer. 111, 762-771.

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2015). Medical-surgical nursing assessment and management of clinical problems. Haryana: Reed Elsevier India Private Limited.

L ymphatic system. (2004). Retrieved from http://slideplayer.com/slide/9984815/

Messersmith, L., Singer, J., & Ciesemier, G. (2015). Utilization of the breast cancer risk assessment tool in the identification and screening of women at increased risk of breast cancer. Journal of Women's Healthcare, 4, 259. doi:10.4172/2167-0420.1000259

Nelson, H. D., Zakher, B., Cantor, A., Fu, R., Griffin, J., O'Meara, E. S.,.Miglioretti, D. (2012). Risk factors for breast cancer for women age 40 to 49: A systematic review and meta-analysis. Annals of Internal Medicine,156(9), 635-648. doi: 10.1059/0003-4819-156-9-201205010-00006

Nettina, S. M. (2010). Lippincott manual of nursing practice. New Delhi: Wolters Kluwer.

Nevidjon, B. M., & Sowers, K. W. (2000). A nurse's guide to cancer care. Philadelphia: Lippincott Williams & Wilkins.

Shah, R., Rosso, K., & Nathanson, S. D. (2014).Pathogenesis, prevention, diagnosis and treatment of Breast Cancer. World Journal of Clinical Oncology, 5(3),283-298.

Stoppler, M. C. (2016). Lymphedema. Retrieved from www.medicinenet.com.

Tortora, G. J., & Derrickson, B. (2011). Principles of anatomy& physiology. New Jersey: John Wiley & Sons.

Yager, J.D., & Davidson, N. E. (2006). Estrogen carcinogenesis in breast cancer. The New England Journal of Medicine. 354(3), 270-82.

Yarbro, C. H., Wujcik, D., & Gobel, B. H. (2011). Cancer Nursing-Principles and Practice. Massachusetts: Jones and Barlett publishers.

Effectiveness of Computer Assisted Teaching Program on Knowledge of Staff Nurses Regarding Telemedicine

* Grace M. Joseph, B.Sc (N)
** Jenimol S. Chacko, B.Sc (N)
*** Sneha A. John, B.Sc (N)
**** Sheela Shenai, M.Sc (N)., Ph.D (N)
***** Preethy Jawahar, M.Sc (N)., M.Phil
****** Soney M Varghese, M.Sc (N)., Ph.D (N)

* IV year B.Sc Nursing student, M.O.S.C. College of Nursing, Kolenchery
** IV year B.Sc Nursing student, M.O.S.C. College of Nursing, Kolenchery
*** III year B.Sc Nursing student, M.O.S.C. College of Nursing, Kolenchery
****Principal, M.O.S.C. College of Nursing, Kolenchery
*****Asst Professor, Community Health Nursing, M.O.S.C. CON, Kolenchery
******HOD, Community Health Nursing, M.O.S.C. CON, Kolenchery

ABSTRACT

Telemedicine is the use of electronic technology to communicate information to provide and support healthcare when distance separates the participants. A study was conducted to evaluate the effectiveness of computer assisted teaching program on knowledge regarding telemedicine among staff nurses. The study adopted one group pretest posttest design, where simple random sampling was used to recruit 70 staff nurses from a selected tertiary level hospital in Ernakulam district, Kerala. The data was collected from the subjects by using a structured knowledge questionnaire. A computer assisted teaching programme on telemedicine was given, a post test was conducted after 7 days and the difference due to the teaching programme was determined by comparing the pretest and post test scores. There was a significant difference (p<.001) in the knowledge scores of staff nurses regarding telemedicine after the intervention. The computer assisted teaching programme was very effective in increasing the knowledge regarding telemedicine among staff nurses.

Keywords: computer assisted teaching program, knowledge, telemedicine

REFERENCES

Bedi, B. S. (2003). Telemedicine in India: Initiatives and perspective. Journal of eHealth. Retrieved from eHealth 2003: Addressing the Digital Divide-17 th Oct. 2003.

Dasgupta, A., & Deb, S. (2008). Telemedicine: A new horizon in public health in India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 33(1), 3.

Ghia, C. J., Ved, J. K., & Jha, R. K. (2013). Benefits of telemedicine and barriers to its effective implementation in rural India: A multicentric e-survey. Indian Medical Gazette. 145(1). Retrieved from http://imsear.hellis.org/ handle/ 123456789/157474

Hanson, D., Calhoun, J., & Smith, D. (2009). Changes in provider attitudes toward telemedicine. Telemedicine and e-Health, 15(1), 39-43.

Khan, I., Dhanalakshami, M. K., & Naveena, J. H. (2015).Effectiveness of SIM on knowledge Regarding telemedicine among the staff nurses. International Journal of Nursing, 1(2).

World Health Organisation. (2010). Telemedicine: Opputunities and developments in member states. Retrieved from http://www .who.int/ goe/ publications/goe_telemedicine_2010.pdf

Knowledge on Risk Driving Behaviour among Road Traffic Accident Victims

* Uma Ramachandran, M.Sc (N)
** Genesta M. Gysel, M.Sc., (N)., Ph.D. (N)

*Vice-Principal, Sabari College of Nursing, Puducherry
** Principal, Sabari College of Nursing, Puducherry

ABSTRACT

Road Traffic Accidents (RTA) are increasing with the increase in the growth of transport system. World Health Organization reports that every year 6,00,000 lives and over 15 million are injured in road traffic accidents. Negative attitude towards driving, drunken driving, not wearing helmets\seat belts, not having license, and over speeding are commonly reported among victims of road traffic accidents. Knowledge influences the attitude of an individual. Hence, a cross- sectional descriptive study was done to assess the level of knowledge on risk driving behavior among RTA victims. A knowledge questionnaire on risk driving behavior was developed and details of accident and injury were also gathered. Out of 60 RTA victims, only 5% had adequate knowledge on risk driving behavior and 50% had various types of fractures because of risk driving behaviors. Special emphasis needs to be given to create awareness traffic rules and safe driving behaviors among public. Programmes should be framed to address the need and make necessary changes in monitoring and controlling risk driving behaviors. Tight monitoring on licensing procedures, and helmet usage and penalties can control these accidents.

Keywords: knowledge, risk driving behavior, road traffic accident, RTA victims

REFERENCES

Dash, D. K. (2009). India leads world in road deaths: WHO. (Aug, 17). The times of India. Retrieved from http://timesofindia.indiatimes.com/india/India-leads- world-in-road-deathsWHO/articleshow/ 4900415. cms

Garg, N., & Hyder, A. (2006). Road traffic injuries in India: A review of the literature. Scandinavian Journal of Public Health, 34(1), 100-109. doi: 10.1080/ 14034940510032149

Hassen, A., Godesso, A., Abebe, L., & Girma, E. (2011). Risky driving behavior for road traffic accidents among drivers. BMC Research Notes,4,535. doi: 10.1186/1756-0500-4-535. Retrieved fromhttp://bmcresnotes.biomedcentral.com/articl es/10.1186/1756-0500-4-535

Mishra, B., Sinha, N. D., Sukhla, S. K. & Sinha, A. K. (2010). Epidemiological study of road traffic accident cases from Western Nepal. Indian Journal of Community Medicine, 35(1), 115 121.

Nikumb, V. B., Banerjee, A., Singh, S. K. (2013).Behaviour related to safe driving among college youth in an industrial township. International Journal of Critical Illness and Injury Sciences, 3(1), 96-97.

Ramos, P., Diez, E., Pérez, K., Rodriguez-Martos, A., Brugal, M. T., & Villalbí, J. R. (2008). Young people's perceptions of traffic injury risks, prevention and enforcement measures: A qualitative study. Accident Analysis & Prevention, 40(4), 1313-1319.

Knowledge and Practice of Nursing Personnel on Antenatal Foetal Assessment before and after Video Assisted Teaching

* Mary Jenifer, M. Sc (N)
** Alice Sony, M. Sc (N)
***Dorothy Singh, M. Sc (N)
****Jessie Lionel, MBBS., D.G.O., M.D., D.N.B (FM)
*****Visalakshi Jayaseelan, M.Sc., Ph.D

* Junior Lecturer, College of Nursing CMC, Vellore
** Professor, College of Nursing CMC, Vellore
*** Professor, College of Nursing CMC, Vellore
**** Professor, Dept of OBG, CMC, Vellore
***** Senior Lecturer, Dept of Biostatistics, CMC, Vellore

ABSTRACT

Risk factors that develop during pregnancy affect foetal oxygen transmission. This can be detected through different methods of foetal assessment. Since nurses are primary care givers, it is imperative for them to have adequate knowledge and practice and the foetal assessment training can be effectively imparted through Video Assisted Teaching. Hence a study was done to assess the knowledge and practice of the nursing personnel on antenatal foetal assessment before and after Video Assisted Teaching. Quasi experimental one group pre-test post-test design was used. A total of 53 nursing personnel were selected using convenience sampling technique. Data were collected using knowledge questionnaire and observation checklist on antenatal foetal assessment which included Non-Stress Test (NST) and Daily Foetal Movement Count Chart prepared by the investigator. The findings revealed that there was an increase in mean scores of knowledge from 14.8 to 21.0 and practice from 11.8 to 24.7 after the Video Assisted Teaching which shows the effectiveness of Video Assisted Teaching on the knowledge and practice of the nurses on antenatal foetal assessment. This study enabled nurses to become competent in doing antenatal foetal assessment in the wards and confidently interpret the readings and inform the doctors accordingly. The structured instructional module prepared by the investigator can be used as guideline for all nurses in the antenatal wards and labour room while the video can serve as a tool for educating students in clinical area. Continuing nursing education sessions on interpretation of NST tracings for nurses may improve their knowledge and skills.

Keywords: nursing personnel, antenatal foetal assessment, non stress test, daily foetal movement count, video assisted teaching

REFERENCES

Altaf, S., Oppenheimer, C., Shaw, R., Waugh, J., & Dixon- Woods, M. (2006). Practices and views on foetal heart monitoring: A structured observation and interview study. BJOG: An International Journal of Obstetrics & Gynaecology, 113(4), 409-418. doi:10.1111/j.1471-0528.2006.00884.x

American college of Obstetrics and Gynaecology. (2007). Clinical guidelines. Retrieved from https:// www.acog.org /About-ACOG/ACOG-Departments Deliveries-Before-39-Weeks/ACOG-Clinical- Guidelines

American Pregnancy Association. (2013). Foetal distress. Retrieved from http://americanpregnancy.org /labor- and-birth/foetal-distress/

Cunningham, F.G., Leveno, K.J., Bloom, S.L., Hauth, J.C., Rouse, D.J. & Spong, C.Y. (2010). Williams Obstetrics. New York : McGraw-Hill publications.

Cunninghum, S. C. (2001). Williams' Obstetrics. New Delhi: Mc Graw Hills publications.

Davies, S., Hauck, Y., Bayes, S., Barrett, T., & Jones, J. (2013). Australian maternity health professionals' experience of an e-learning foetal surveillance package. Evidence Based Midwifery, 11(4), 138-142.

Dover, S. L., & Gauge, S. M. (1995). Foetal monitoring midwifery attitudes. Midwifery, 11(1), 18-27.

Hammacher, K. (1962). New method for the selective registration of the foetal heart beat. German Geburtshilfe Frauenheilkd, 22, 1542-1543.

Hillis, D.S. (1917). Attachment for stethescope. Journal of American Medical Association, 68, 910.

Murphy, A. A., Halamek, L. P., Lyell, D. J., & Druzin, M. L. (2003). Training and competency assessment in electronic foetal monitoring: A national survey. Obstetrics & Gynecology, 101(6), 1243-1248.

Perinatal Epidemiology Research Unit. (2013). Neonatal- Perinatal Medicine. Retrieved from https:// medicine.dal.ca /departments/department- sites/pediatrics/patient-care.html

Thacker, S. B., Stroup, D., & Chang, M. (2001). Continuous electronic heart rate monitoring for foetal assessment during labor. Cochrane Database of Systematic Reviews, 2.

Warrander, L. K., & Heazell, A. E. (2011). Identifying placental dysfunction in women with reduced foetal movements can be used to predict patients at increased risk of pregnancy complications. Medical hypotheses, 76(1), 17-20.

Effectiveness of Progressive Muscle Relaxation Therapy in Reducing the Affective Symptoms in Pre- Menstrual Syndrome among the Young Adult Girls

* Shanthi Thirupathi, M. Sc (N)

* Associate Professor, Godavari College of Nursing, Jalgoan

ABSTRACT

Pre-menstrual Syndrome (PMS) is a common condition that affects a woman's emotions, physical health, and behavior during certain days of the menstrual cycle, generally just before her menses. Premenstrual syndrome substantially reduces quality of life for many women of reproductive age, with pharmaceutical treatments having limited efficacy and substantial side effects. Physical activity has been recommended as a method of reducing menstrual symptom severity. The objectives of the study were to assess the pre and posttest scores of affective symptoms in PMS among young adult girls in experimental and control group, and to determine the effectiveness of progressive muscle relaxation therapy on affective symptoms in PMS. An evaluative research approach was conducted with true experimental pretest- posttest control group research design to accomplish the objective. The sample comprised of 60 young adult girls. Data were collected using modified women's quality of life rating scale and analyzed using descriptive and inferential statistics. Majority of population under the age group 18 years (36.6%) had more affective symptoms of PMS and the population under 21 years age group (10%) had less affective symptoms of PMS. Majority of population in which the age at menarche was less than 11 years (46.67%) had symptoms of PMS and those who attained menarche after 16 years (3.33%) had less affective symptoms. The posttest mean premenstrual syndrome score (22.03+ 7.26) was less than the pretest mean premenstrual syndrome score (38.34+ 22.03). The results showed that progressive muscle relaxation therapy had an effect to reduce premenstrual syndrome in young adult girls. Therefore it can be employed to reduce affective symptoms of premenstrual symptoms among young adult girls.

Keywords: premenstrual syndrome, progressive muscle relaxation therapy, young adult girls

REFERENCES

Aruna, S. (2012). Effectiveness of cognitive behavioral nursing strategies on premenstrual syndrome (PMS) among adolescent girls. Retrieved from http:// shodhganga.inflibnet.ac.in/handle/10603/17912

Davis, M., Eshelman, E. R., & McKay, M. (2008). The relaxation and stress reduction workbook. New Harbinger Publications.

Direkvand-Moghadam, A., Sayehmiri, K., Delpisheh, A., & Kaikhavandi, S. (2014). Epidemiology of Premenstrual Syndrome (PMS)-A systematic review and meta- analysis study. Journal of Clinical Diagnostic Research, 8(2), 106. Doi:10.7860/jcdr /2015/8024.6296

Jasuja, V., Purohit, G., Mendpara, S., & Palan, B. M. (2014).Evaluation of psychological symptoms in premenstrual syndrome using PMR technique. Journal of Clinical and Diagnostic Research, 8(4), BC01.

Kroll-Desrosiers, A. R., Ronnenberg, A. G., Zagarins, S. E., Houghton, S. C., Takashima-Uebelhoer, B. B., & Bertone-Johnson, E. R. (2017). Recreational physical activity and premenstrual syndrome in young adult women: A Cross-Sectional Study. PloS one, 12(1), e0169728.

O'Brien, P. M. (1993). Helping women with premenstrual syndrome. British Medical Journal, 307(6917), 1471.

Patil, S.N., Wasnik, V., & Wadke, R. (2009). Health problems amongst adolescent girls in rural areas of Ratnagiri district of Maharashtra India. Journal of Clinical and Diagnostic Research, 3(5), 1784-1790. Retrieved from http://www.jcdr.net/ back_issues.asp? issn=0973-

Sharma, P., Malhotra, C., Taneja, D.K., & Saha, R. (2008). Problems related to menstruation amongst adolescent girls. Indian Journal of Pediatrics, 75(2):125-129. doi:10.1007/s12098-008-0018-5

Stachenfeld, N. S. (2008). Sex hormone effects on body fluid regulation. Exercise and Sport Sciences Reviews, 36(3), 152.

Wyatt, K. M., Dimmock, P. W., Jones, P. W., & O'brien, P. S. (1999). Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: Systematic review. British Medical Journal, 318(7195), 1375-13.