92 research outputs found
“SU JOK” THERAPY AND SCLEROLOGY PROFILE MONITORING FOR MANAGING CHEST PAIN AT HOME WHILE AVOIDING HOSPITAL ADMISSION DURING THE COVID-19 PANDEMIC: A CASE STUDY
No full textAbsconding from a psychiatric setting in Indonesia: a case study
No full textPatients absconding from psychiatric settings are a phenomenon that has increasingly caught the attention of nursing researchers in Western countries. This phenomenon also occurs in psychiatric hospitals in Indonesia. However, this is not a topic that has received a great deal of attention in terms of research in Indonesia.
The aim of the study is to provide a profile of absconding events over a one-year period in one psychiatric setting. The objectives of the study are to:
• identify demographic patterns associated with all patients who abscond from one psychiatric hospital during a one-year period;
• describe the experience of patients and nurses related to incidents of absconding;
• identify the contextual factors that promote and obstruct absconding behaviour; and
• discuss the ways in which absconding events in this case differ or are similar to reports of absconding in the West.
A case study using mixed methods and concurrent triangulation has been undertaken in order to provide a profile of absconding events over a period of one year in a psychiatric hospital in Indonesia. Data included a one-year audit of absconding events, a period of observation, and interviews with patients and nurses.
Over a one-year period of data collection 133 absconding events were recorded that involved 106 patients. The predominant pattern of people who abscond is that they are young male patients with a history of previous admission. 70% of patients return to the hospital on the day of absconding. On the face of it, this information is consistent with findings in the West, however qualitative data reveals significant differences.
Sixteen patients who absconded during a seven-month period of data collection were interviewed. Three themes were identified: ‘The call to home’, ‘Hopes and realities’ and ‘Us and them’. All these themes link to the process of recovery. ‘The call to home’ and hopes for happier life are considered as the first step in the process of recovery. ‘The call to home’ reflected the patients’ eagerness to have connection with their family and to feel safe. Patients hope to experience a happier life, however most of their hopes are dashed as they fail to reach home or their family sent them back to hospital. The last theme is ‘Us and them’ in which the patients describe the differences between them and others, and the consequence of the differences which create negative feelings and forms a barrier to developing and growing towards recovery.
Observations and interviews with 24 nurses reveal a style of nursing that is custodial rather than therapeutic. The days are filled with routine duties, and opportunities to prepare patients for discharge as an important part of the recovery process, are missed. The nursing staff is disappointed with the attitude of the family and community towards people with mental health problems and believes that families are responsible for patients once they are ready for discharge.
The majority of patients who absconded from the hospital in this study were ready for discharge and awaiting collection by their family. They were considered to be in the process of recovery, but it appears that there is little adequate support for patients who are ready to be discharged from hospital. It is not unusual for patients who have absconded to be brought back to hospital again by their family if they are not well received in the community.
Short term recommendations centre on the rehabilitation focus and activities in the hospital. Nurses should become more involved with interventions that are appropriate in rehabilitation processes and see it as an integral part of discharge planning included in management plans. In the longer term, nurses require resources to support their education and the implementation and evaluation of person-centered models of care. Strategic plans should be implemented to change public and professional attitudes towards people with a mental health problem. Further research on this topic is required to understand family and community attitudes, recovery from a range of perspectives and test alternative models of nursing care
VALIDITY AND RELIABILITY OF NURSING INTERVENTION CLASSIFICATION: SELF-CARE ASSISTANCE ON PATIENTS WITH STROKE
No full textVALIDITY AND RELIABILITY OF NURSING INTERVENTION CLASSIFICATION: SELF-CARE ASSISTANCE ON PATIENTS WITH STROKE
No full textBackground: Nursing intervention is part of nursing process. The accurateness of intervention needs to be explored through an effort to measure validity and reliability of the intervention.
Objectives: This study aimed to investigate the validity and reliability of four Nursing Intervention Classifications (NICs) of Self-Care Assistance (SCA) on patients with stroke.
Methods: Validity measurement involved 4 experts, while reliability involved 7 samples for each NIC. Validity was analyzed using content validity index (I-CVI and S-CVI), while reliability was analyzed using kappa and percent agreement.
Results: Sixteen activities of NICs (I-CVI score less than 0.78) were eliminated and two activities considered not applicable. The results of reliability were above 0.85 kappa value with 85% of percent agreement.
Conclusion: Elimination of not valid activities increased reliability
Su Jok Therapy for Managing Chest Pain During COVID-19 Pandemic Period: A Case Report
No full textThe Covid-19 pandemic has led people who were non-COVID-19 patient to avoid hospital admission and to seek help from alternative medicine. The aim of this report is to describe the management of chest pain at home using Su Jok therapy. Case report: A male 47 of years old complained of chest pain with difficulty breathing and asked for help from the researcher who was a nurse as well as Su Jok therapist. His sclera profile was recorded for analysis (sclerology analysis). Su Jok therapy was applied directly by the researcher on daily basis. Researcher also monitored his condition progress through checking pain point on his hands and also from his sclera profile. After two weeks, the symptoms subsided and the eye’s profile of sclera shows healing progress. Conclusion: The case study shows that Su Jok therapy may become an alternative therapy for managing chest pain
Sujok triorigin therapy for vaginitis: case reports
No full textVaginitis cases are the most frequently encountered cases of gynaecologists in women who seek treatment at health facilities. Various therapies are sought by sufferers to overcome this condition. This case report discusses the use of Sujok triorigin therapy with the mudra method to treat the symptoms of vaginitis. Mudra method is the therapy only by using the thumb placed on certain knuckles based on the tri-origin concept and the respondents meditate for 15-20 minutes. There was no charge applied for the therapy were given to the patient. Two female patients on their 40s contacted researcher through social media to get help for their vaginitis problems. Researcher sent the instruction through picture how to apply the therapy on patients’ fingers. In the first case, this extreme vaginal itching condition had been experienced for 1 year with various treatment methods tried but none were successful. In this respondent, it took 9 days for the itching to completely disappear with therapy being done 4 times a day for about 15 minutes. The second respondent complained of extreme itching in the vagina, with a severity scale of 5 (from 1-5) and bleeding because of scratching. After 4 minutes of doing mudra, the itching went down to scale 3 and after 20 minutes the itching went down to a score of 1-2 and then was completely gone after that. In conclusion, Sujok triorigin therapy can reduce vaginitis symptoms in two respondents in a relatively short time of therapy
Connecting care for individuals living with a mental health issue in Indonesia: a grounded theory study
No full textMental health services are not a priority in the Indonesian health system. Insufficient resources are allocated, resulting in shortfalls in key performance indicators for mental health services. Overall, facilities and human resources are inadequate which means that mental health services do not function at their best. The impact of these inadequacies can be seen when individuals living with a mental health issue experience the 'vicious cycle' of a 'revolving door' between psychiatric institutions and the community. Individuals living with a mental health issue wander on the streets - a visible consequence of an inadequate mental health system. In extreme cases, shackling (or other physical restraint) of individuals living with a mental health issue occurs because the family cannot afford the cost of treatment. To date, there has been little research undertaken in Indonesia that investigates the way in which mental health care is delivered.
The aim of this grounded theory study was to generate a theoretical model of collaborative care for individuals living with a mental health issue in Indonesia. The findings will contribute to the evidence base concerning the provision of mental health care in this country. Data were collected during three field trips between 2011 and 2012. Forty-nine participants were interviewed including health professionals and non-health professionals, individuals living with a mental health issue, cadres (a term that in Indonesia refers to mental health volunteers), families and community leaders. The interviews were recorded and transcribed in Indonesian before being analysed using grounded theory methods of concurrent data collection and analysis: initial, intermediate and advanced coding and theoretical sampling. The grounded theory of connecting care for individuals living with a mental health issue explains in part how mental health care is delivered in Indonesia. The core category was connecting care. Three categories were constructed in the development of this theory and these categories are decision-making, shifting responsibility and accepting responsibility. Of these three categories, decision-making was found to be central to the provision of care by health professionals and non-health professionals. Decision-making is characterised by four properties, each one of which influences individual stakeholders to varying degrees. These properties are level of resources; competency of the individual to provide care; willingness to provide care; and compliance with official policies. When making a decision, stakeholders such as doctors, nurses, carers and family members, will either shift responsibility or accept responsibility to provide care. The success and effectiveness of shifting responsibility is largely influenced by the quality of communication between stakeholders. Accepting responsibility is influenced by resources, competency and willingness.
The most influential factor for health professionals is following the rules of institutional policy when they make decisions about whether to shift or accept responsibility to provide care. Decision-making for non-health professionals, however, is influenced more heavily by personal circumstances. These circumstances include competence, willingness, resources and compliance with policy. Negotiations between health professionals and non-health professionals about the provision of care can result in either matched or unmatched decision-making. Matched decision-making leads to the unforced acceptance of responsibility and results in optimum health outcomes. Unmatched decision-making can result in health professionals and non-health professionals (especially families) being forced to provide a level of care that exceeds their competency and resources. Unmatched decision-making also results in individuals being forced into psychiatric institutions for unnecessarily long periods of time. Forced acceptance of responsibility leads to adverse health outcomes and can increase the risk of human rights violations and the burden of care.
Several recommendations arise from this study. The first recommendation is that the Indonesian Government should establish a mental health act and accompanying regulations to serve as a guideline for all stakeholders who make decisions to shift or accept responsibility for care. The second recommendation is to apply a series of strategies aimed at reducing families’ burden of care. These strategies include providing social networks (groups) for families and providing education for non-health professionals, such as community members, to help them better understand mental health and the needs of consumers. Mental health services, both in psychiatric institutions and in the community, also need to be more accessible to individuals living with a mental health issue and for their families. The provision of financial support for individuals living with a mental health issue and their families is also crucial. The final strategy proposed is that the Indonesian Government provides an increased and adequate number of competent health professionals to meet the needs of individuals living with mental health issues and their families in the community.
This grounded theory explains the process of collaborative care for individuals living with a mental health issue. The product of this grounded theory study also can explain the three phenomena that prompted this study: the vicious cycle of the revolving door for people with mental illness, wandering cases and shackling (or other physical restraints). It is hoped that the theory of connecting care can be used as a framework to improve mental health service delivery in Indonesian cities, towns and regions with a subsequent improvement in patient outcomes
Guidelines for analysis on measuring interrater reliability of nursing outcome classification
No full textIndicators in nursing outcome classification (NOC) need to be tested for their validity and reliability. One method to measure reliability of NOC is by using interrater reliability. Kappa and percent agreement are common statistic analytical methods to be used together in measuring interrater reliability of an instrument. The reason for using these two methods at the same time is that those statistic analytical methods have easy reliability interpretation. Two possible conflicts may possibly emerge when there are asynchronies between kappa value and percent agreement. This article is aimed to provide guidance when a researcher faces these two possible conflicts. This guidance is referring to interrater reliability measurement using two raters.</jats:p
The most frequent diagnosis on patients undergoing hemodialysis
No full textBackground: Hemodialysis is a routine medical intervention for patient with chronic renal failure. Patients may responds differently when they undergoing this procedure. Investigating nursing diagnosis and collaborative diagnoses during hemodialysis procedure need to be explored. The objective of this research is to determine the sequence of nursing diagnosis and the collaborative diagnosis identified among kidney disease patients who are undergoing hemodialysis.Methods: This case study research involving 62 respondents. Research was conducted between June and July 2015. The respondents’ cases were studied to determine what nursing diagnoses and collaborative diagnoses, using a six-step diagnostic reasoning method.Results: Result of this study showed 27 nursing diagnoses and 7 collaborative diagnoses experienced by the patients. The six most commonly experienced nursing diagnoses were: activity intolerance (100%), nausea (96.8%), risk for impaired skin integrity (91.9%), impaired urinary elimination (82.3%), insomnia (77.4%), and sexual dysfunction (58.1%).Conclusions: There were 27 nursing diagnoses and 7 collaborative diagnoses that were experienced by patients who were undergoing hemodialysis
Komunikasi keperawatan: dasar-dasar komunikasi bagi perawat
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