Journal of Lumbini Medical College (JLMC)
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Nursing Students’ Perception of Online Learning Amidst COVID-19 Pandemic
Get PDFIntroduction: The declaration of COVID-19 pandemic on 11th March 2020 by World Health Organization forced many countries including Nepal to choose online mode of nursing education. Hence, it is essential for the educators to find out students’ perception that ensures their readiness to learn in this new environment. This study sought to examine the perception of online learning among nursing students. Methods: After obtaining ethical clearance, a cross-sectional descriptive study was conducted among 211 nursing students using enumerative sampling method. Self-administered structured online questionnaire was used. Calculated Cronbach\u27s alpha value was 0.828. Descriptive (frequency, percentage, mean etc.) and inferential statistics (Chi-square test) were used to analyze data. Results: The mean age of the participants was 19.80±1.87 years. All (100%) had mobile phone. Most (93.8%) had internet facility at home. More than half (59.7%) strongly agreed that face-to-face learning was more effective. Less than half (44.6%) strongly agreed that interrupted internet connection was an obstacle. More than half (56.9%) participants had positive perception of online learning. Age, enrolled nursing program and device used were statistically significant with perception of online learning. Conclusion: The perception of nursing students towards online learning is positive. Students are satisfied with their learning opportunities amidst COVID-19 through online education. However, interrupted internet connection, unfeasible practical natured courses, load-shedding etc. were perceived as obstacles to online learning. Age, enrolled nursing program, academic year, and devices used had an impact on positive perception
Assessment of Mental Health Problems of School Children Using Self Report Strengths and Difficulties Questionnaire
Get PDFIntroduction: Psychological disorders among children and adolescents are the least discussed health problems in pediatrics. There is limited data on the prevalence of mental health problems among adolescents in low-income countries like Nepal. This study intended to find the prevalence of mental health problems among school children in a secondary school in western Nepal. Methods: In this descriptive cross-sectional study, students of grades six to eleven of two private schools of a district in Nepal were randomly selected. The self-rated version of Goodman’s Strength and Difficulty Questionnaire were used to assess mental health problem in these adolescents. Outcomes were measured in a scale of zero to 10 for each of emotional, conduct, hyperactivity, peer problem and pro-social behavior. Difficulty scale and its impact on life were also measured. Results: Out of 902 students, 5% (n=49) had significant and 14% (n=127) had probable mental health problem. Peer problems was the commonest (25%) followed by emotional (15%) and conduct problem (15%) and hyperactivity and pro-social problems were seen in 7% each. Boys had more mental health problem than girls except emotional problem. Mental health problem was more common in lower grade or younger age students. Its impact on life were 0-7.4%. Abnormal internalizing and externalizing problems were reported in 20% and 11% respectively. Conclusion: Mental health problem was prevalent (5 to 25%) in secondary school children. Screening school children for the same would be beneficial for early diagnosis
Clinical Nurses’ Knowledge and Attitude on Palliative Care: A Cross-Sectional Study
Get PDFIntroduction: Palliative care is a multidisciplinary approach for enhancing the quality of life of terminally ill patients. For nurses, being the core members of the palliative care team, adequate knowledge and a positive attitude are crucial. This study aimed to assess clinical nurses\u27 knowledge and attitude on palliative care. Method: A cross-sectional descriptive study was conducted among 122 nurses. A simple random sampling technique was applied to select the sample. Internationally validated questionnaires-“The Palliative Care Quiz for Nursing†and “Frommelt Attitudes Toward Care of the Dying Scale†were used to assess knowledge and attitude. Data were analyzed using descriptive statistics and inferential statistics. Results: The mean age of participants was 25±5.42 years and a majority (70.5%) were staff nurses. None of the participants had ever received training or in-service education related to palliative care. Only 29.5% had a fair level of knowledge and, 28.7% had a good level of attitude towards palliative care. Pearson correlation test revealed a negligible correlation between the level of knowledge and attitude (r= 0.135, p=0.887). Ethnicity (p=0.02) and religion (p=0.02) were statistically significant with the level of knowledge and care for dying relatives (p=0.03) was statistically significant with the level of attitude. Conclusion: The study revealed that nurses’ have poor knowledge of palliative care but had a fair attitude. As nurses are core members, regular training and in-service education can enhance their knowledge level. Positive reinforcement, appreciation, and reward for desirable behavior can help them develop a good attitude towards palliative care
Effect of Anemia in Pregnancy and its Perinatal Outcome: A Prospective Cohort Study
Get PDFIntroduction: Anemia is a major risk factor for poor maternal health status. Anemia during pregnancy leads to poor birth outcomes such as fetal anemia, low birth weight, preterm birth, stillbirth, and neonatal mortality. This study aimed to assess the effect of anemia in pregnancy and its perinatal outcome. Methods: A prospective study was conducted among 370 pregnant women in Dhulikhel Hospital, Kavre from June 2017 to December 2017. Descriptive statistics were used to represent the socio-clinical characteristics. Bivariate analysis was performed to analyze the effect of anemia. Results: The study found that all the participants were anemic out of which mild anemia was observed in 352 (95.4%), moderate anemia in 17 (4.6%), and severe anemia in one (0.3%) participants respectively. Women aged 17 to 24 years and multiparous women had higher odds of having moderate anemia (Hb 7.0-8.9 g/dL). Women with moderate anemia had more odds of having neonates with less Apgar scores. Women with moderate anemia had nine times higher odds of having newborn mortality. Conclusion: Anemia during pregnancy not only affects the health status of the mother but also impacts the birth outcomes. This study highlighted the emphasis on the active participation of governmental and non-governmental organizations to prevent adverse effects of anemia during pregnancy and birth outcomes
Fatigue and Sleep Quality Among Staff Nurses Working in A Tertiary Care Hospital During COVID-19 Pandemic
Get PDFIntroduction: Fatigue, a universal phenomenon, is a suboptimal psychophysiological condition caused by physical and/or mental exertion. Insufficient recovery between work shifts causes accumulated acute fatigue to progress into chronic. As fatigue and sleep quality are related, adequate sleep and inter shift recovery are thus vital to the overall health. The current COVID-19 pandemic has caused added burden to the nursing workforce worldwide. This study aimed to assess fatigue and sleep quality among staff nurses of a tertiary care hospital during the pandemic. Methods: A descriptive cross-sectional study was conducted among 151 staff nurses of Lumbini Medical College and Teaching Hospital (LMCTH) using enumerative sampling method. Valid and reliable instruments i.e., Occupational Fatigue Exhaustion Recovery (OFER) and Pittsburgh Sleep Quality Index (PSQI) were used. Analysis was done using descriptive and inferential statistics. Results: The mean ±SD age of the participants was 26.54±6.93 years. Less than half (39.1%) of them had moderate to high acute fatigue. Nearly half (41.2%) had high chronic fatigue and most (61.6%) had low to moderate inter shift recovery. Poor sleep was found among 60.9% of the participants with mean global PSQI score of 6.74. Sleep quality had moderate positive correlation with chronic (r=0.4, p<0.001) and acute (r=0.39, p<0.001) fatigue whereas had moderate negative correlation with inter shift recovery (r=- 0.41, p<0.001) which were statistically significant. Conclusion: The staff nurses had fatigue and poor sleep during COVID-19 pandemic. Nursing administration should take appropriate measures timely to decrease fatigue and improve sleep to prevent serious consequences
Pregnant Women’s Mental Health Status and its Related Factors Amidst COVID-19: A Cross- Sectional Study
Get PDFIntroduction: Since the emergence of COVID-19 pandemic, it has challenged the psychological aspect of everyone. Pregnant women being the vulnerable group are most likely to be at increased risk. This study aimed to assess the mental health status of the pregnant women residing in Nepal during COVID-19. Methods: A cross-sectional online study was carried out among 368 pregnant women during lockdown using Perceived stress scale-10, Generalized Anxiety Disorder-7 scale and Edinburg Perinatal Depression Scale. Data were analyzed using descriptive and inferential statistics. Results: The mean age of the participants was 27.06±4.64years. Getting infected with the virus (71.7%) was the major fear and inadequate antenatal checkup (61.1%) was the major effect experienced by the participants. The prevalence of stress, anxiety and depression was 41%, 28.5% and 33.2% respectively. Age, salary status of oneself and their husband, healthcare frontliner in the family and effect of social distancing were significantly associated with perceived stress. Age, education, employment, monthly income, trimester and effect of social distancing were significantly associated with anxiety. Salary status of husband, trimester, parity, being infected with COVID-19 and effect of social distancing were associated with depression. Conclusion: High prevalence of mental health disorders during COVID-19 outbreak suggests the importance of special attention on monitoring the maternal mental health status during such public health emergencies. Measures such as awareness program targeted to pregnant women and health education programs on how to cope during the pandemic situations should be made effective to rule down the mental health burden of COVID-19
Pharmacovigilance: Knowledge, Attitude and Practice among Medical Professionals at a Tertiary Care Hospital in Nepal
Get PDFIntroduction: Awareness regarding pharmacovigilance and adverse drug reaction reporting by medical professionals significantly contribute to the safer use of medicine. Therefore, the objective of this study was to assess the knowledge, attitude, and practices regarding pharmacovigilance among the medical professionals at a tertiary care hospital in Nepal. Methods: This study was a descriptive cross-sectional study conducted at Lumbini Medical College and Teaching Hospital. Printed questionnaires were distributed to all the medical professionals and collected data were analyzed to find the knowledge, attitude, and practices of the medical professionals regarding pharmacovigilance. Results: A total of 107 medical professionals, 77 (71.96%) males and 30 (28.04%) females, participated in the study. The overall response rate was 98.16%. In this study,70.1% of medical professionals knew the definition of pharmacovigilance, and more than half of the participants(63.6%) did not know the existence of the national pharmacovigilance center. Regarding attitude, 52.3% of the medical professionals strongly agreed that adverse drug reaction reporting and monitoring systems were beneficial to patients or improved patient care. Half of the medical professionals would sometimes counsel the patients about adverse drug reactions. Almost half of medical professionals mentioned that the major factor behind underreporting was insufficient knowledge of where to report adverse drug reactions. Training on pharmacovigilance was the main recommendation from the participants (52.3%) to improve the pharmacovigilance program. Conclusion: There is room for improvement in the knowledge, attitude and practice of the participants. Most medical professionals suggested training or continuing medical education as a way to improve pharmacovigilance programs
Pre-operative Hypoglycemia in Patients Presenting for Surgery: A Hospital Based Cross-sectional Study
Get PDFIntroduction: Peri-operative glycemic control is an important factor for post-operative recovery and is well protocoled for diabetic patients in every setup. It is not always so with non-diabetic patients. This study aimed to observe the pre-operative glucose level and prevalence of hypoglycemia in patients presenting for surgery and its association with the duration of nil per oral period (NPO), age and intravenous fluids used in the pre-operative period. Methods: A cross-sectional study was conducted in the Department of Anesthesiology in a Nepalese medical college including all the patients posted for elective surgery over a period of three months. Socio-demographic and clinical details of the participants were collected in the operating theatre. Duration of NPO period and intravenous fluid prescribed in the pre-operative fasting period were recorded. A glucose strip test was performed on all the participants. Results: Participants were found to have fasted for an unnecessarily longer duration (12.84±2.27 hours). The incidence of hypoglycemia in patients posted for elective surgery was very high (43.3%). Ringer lactate and normal saline were equally prescribed (38.4%) and dextrose-normal saline was prescribed in the rest of the participants. Gender and type of intravenous fluids were positively correlated whereas NPO period was negatively correlated in overall participants though statistically insignificant. In hypoglycemic participants, we observed that lower glucose was influenced by pre-operative fluids, age and NPO duration. Conclusion: Pre-operative use of glucose-containing fluids during NPO period is an important step to prevent hypoglycemia and related consequences
Menopausal Symptoms in Premenopausal Women Among the Cohort of Gynecological Patients Attending Outpatient Department of Dhulikhel Hospital.
Get PDFIntroduction: Perimenopause is the time when ovaries gradually produce less estrogen. The menopausal symptoms in perimenopausal women cause severe disturbance in the women’s life. This study aimed to identify menopausal symptoms in perimenopausal women. Methods: This was a hospital-based descriptive, cross-sectional study conducted among 243 women aged between 45 to 55 years. The categorical variables were presented as frequency and percentage. The associations between categorical variables were tested using Chi-square or Fisher exact test. Result: The total prevalence of menopausal symptoms was 91.8%. Physical symptoms were identified to be prevailing symptom(n=184, 75.7%) followed by psychological (n=167, 69.5%). There were 136 (55.5%) women experiencing poor memory and 148 (60.9%) women having genitourinary symptoms. Stress urinary incontinence (n=73, 30.04%) was predominant over urge (n=58, 23.8%), mixed (n=43, 17.6%) and prolapse (n=49, 20.1%) symptoms. Vasomotor symptoms were experienced by123 (50.6%). Excessive sweating (n=114, 46.9%) was leading over hot flush(n=113, 46.5%), night sweat (n=107, 44.03%) and palpitation (n=96, 39.5%). A total of 114 (46.9%) women were facing sexual symptoms. The common sexual symptom was dyspareunia 68 (27.9%). The Menopausal Rating Scale (MRS) rating of overall symptoms showed women mostly suffer from mild symptoms during the perimenopausal period. Conclusion: Physical symptoms were identified to be predominating followed by psychological, genitourinary, vasomotor, and sexual. However rating of symptoms using MRS showed the majority of symptoms were mild. This study signifies the need to use the tool for the assessment of the severity of menopausal symptoms from the perimenopausal group
Estimating the Height of An Individual from The Length of Ulna in Undergraduate Students of a Nepalese Medical College
Get PDFIntroduction: Estimation of height from bones plays an important role in identifying unknown bodies, parts of bodies, or skeletal remains. Multiple anthropometric techniques have been used to estimate stature from skeletal remains by anthropologists, anatomists, and forensic experts. The ulna is a long bone often used for body height estimation, as it is mostly subcutaneous throughout its length and is easily approachable for measurement. Methods: The present study was carried out on 100 (57 male and 43 female) undergraduate students of a medical college of the age group of 18 to 24 years. The parameters studied were height, length of right, and left ulna. The observations were analyzed by Pearson’s correlation to examine the relationship between the length of ulna and height. Results: The mean height of males was 174.54 ± 13.32 cm and of females was 156.01±11.19 cm. The mean length of the right ulna was 27.36 ± 2.12 cm (males) and 24.35±1.97 cm (females). The mean length of the left ulna was 27.29 ± 2.13 cm (males) and 24.06 ± 2.18 cm (females). Pearson’s correlation showed a positive and statistically significant (p<0.001) relation between the length of the ulna and the height. The regression equation was derived to estimate the height of an individual from the length of the ulna. Conclusion: The ulna bone length is an accurate parameter that can be used in estimating an individual\u27s height. The regression equation derived in this study can be of great help to anatomists, clinicians, anthropologists, and forensic scientists