Day 3 :
- Public Health, Geriatric Nursing & Cancer Nursing
Chair
Heather MacDonald
University of New Brunswick, Canada
Co-Chair
Shahid Sheikh
Ohio State University College of Medicine, USA
Session Introduction
Laura Terriquez-Kasey
Binghamton University, USA Title: Legal and ethical considerations when delivering end
Title: Disaster Preparedness Education Program for Elders in the Community : The Geriatric Passport Project
Time : 09:00-09:20
Biography:
Laura Terriquez-Kasey is an Associate Professor at Binghamton University, teaching since 2000. He is currently teaching three courses in Disaster Preparedness Certificate Program for graduate nurses. He has completed his DNP specialization in Geriatrics (2015). He has been an Advanced Practice Nurse in Administration with a sub-specialization in Emergency and Trauma Care. He has served for 14 years with New York DMAT-2 and 20 years in the Army Nurse Corp. He was a Nurse Manager for Emergency services for many years and spent 12 years at Bellevue Hospital as an Emergency Nurse Leader.
Abstract:
Over the last half century, the frequency and intensity of tornados, floods and other severe weather events have underscored the need for disaster preparedness, particularly for older adults. Functional limitations, cognitive decline and medical comorbidities such as heart disease and diabetes create additional vulnerabilities, regardless of the type of disaster. Still, elders are capable of self-identifying needs and can be empowered to prepare communication plans, assemble disaster kits and learn how to respond to threats posed by specific disasters. By increasing the level of disaster preparedness through training, many of the health problems faced by elders during a disaster could be alleviated and their overall response improved. Yet despite their abilities and the known benefits of disaster preparedness, disaster education and planning for elders has not been widely implemented. This project hopes to change this in these rural communities. The purpose of the Geriatric Passport Project was to increase the level of disaster preparedness through implementation of a disaster education program among community-dwelling older adults over the age of 55. Recruitment strategies included media, engaging key staff from program sites, and word of mouth. The project used a pre-post reflexive control design. Knowledge about the elements to include in a disaster communication plan increased as did knowledge about items to include in a disaster kit. Notably, self-rated level of stress associated with evacuation to a shelter remained unchanged. Most importantly, the perceived level of disaster preparedness increased, suggesting that those who participated in the Geriatric Passport Project felt more prepared to respond to a disaster as a result of having attended the disaster education program. The Geriatric Passport Project appears to have beneficial effects and the success of the pilot project supports exploring the feasibility of expanding the program to a wider geographic region and conducting a more rigorous evaluation of program effectiveness, efficacy and efficiency.
Edward L King
City University of New York, USA
Title: Legal and ethical considerations when delivering end of life care to a pediatric client at home
Time : 09:20-09:40
Biography:
Edward L King is a Practicing Lawyer for 27 years as well as a Registerd Nurse for over 30 years. As an RN he has worked in a variety of fields icluding pediatrics and has worked with hospice in the home for the last 14 years. He attended Law School at the Benjamin N. Cardozo School of Law, Yeshiva University and completed his EdD at Dowling College. His dissertation examined the right to refuse care in New York State from 1914 to 2008. He did his Post-doctoral studies at Yale University’s Interdisciplinary Center for Bioethics in 2013. He is presently teaching Nursing as an Associate Professor at Hostos Community College, part of the City University of NewYork.
Abstract:
The home care team caring pediatric clients at home follow a different set of laws and ethical rules than when caring for a competent adult. A competent adult is free to refuse medical care, when it does not endanger others and he has an understanding of the consequences. This set of patients can utilize healthcare directives, such as a Living Will or a Healthcare Proxy. Neither a pediatric patient, nor their parent, is completely able to refuse medical care when their medical doctor is of the opinion that a certain course of treatment will benefit the child. Therefore, conflicts may arise between the healthcare team caring for the child, as well as between the parents, when there is disagreement over the treatment plan. This is especially true, when end of life care is being delivered to a pediatric client at home and the events are accompanied by high level of emotions. These emotions may arise not only from the present end of life situation but from unresolved conflicts between individuals, either in the family or in the healthcare team, caring for the client. This lecture will examine the ethical obligations that a healthcare provider owes to a child, their family and the rest of the healthcare team. It will provide options to understand the state and federal laws that govern pediatric care at the end of life. Lastly, it will provide options on how to recognize ethical dilemmas and how to constructively address them within the healthcare system.
B. Suzy Diggle-Fox
New York Institute of Technology, USA Title: Lifelong Learning: A constructivist grounded theory study
Title: Suicide Risk Assessment in a High-Risk Population: The Elderly
Time : 09:40-10:00
Biography:
B Suzy Diggle-Fox has completed her PhD from Capella University as a Nurse Educator, Master’s of Science from Hunter College and her BSN from Downstate Medical Center. In addition, she has had experience as a Nurse’s Aide and a Licensed Practical Nurse. She is both a Geriatric and an Adult Nurse Practitioner. She has been a Geriatric Nurse Practitioner since 1988 and has practiced within various areas, for example 9 years at the Veteran’s Administration and 10 years at Gurwin Jewish Geriatric Nursing and Rehabilitation Center. At present, she is a full-time tenure track faculty member at New York Institute of Technology.
Abstract:
Geriatric suicide is continuing to rise and, as the older population increases, so will the rate of suicide. The United States has the largest number of suicides within the elderly population. It is estimated that every hour and a half a geriatric individual will commit suicide. Nurse practitioners (NP) and other primary care providers (PCP) are in ideal positions to be able to screen for at-risk individuals in the elder population. Some PCPs may not feel competent in screening for suicide. The NP/PCP should be able to collaborate with mental health professionals to facilitate counseling, medication, and other supportive services to reduce suicide risk and incidence. If primary care providers learn more about risk factors, assessment areas to explore and ways to improve treatment the incidence of suicidal behaviors will have better statistical odds of decreasing.
Canan Karadas
Hacettepe University, Turkey
Title: The effect of range of motion exercises on delirium prevention among patients aged 65 and over in intensive care units
Time : 10:00-10:20
Biography:
Canan Karadas was graduated from Abant Izzet Baysal University, School of Nursing and has started to work as a Research Assistant since 2013. Her fields of interest are intensive care, mobility and geriatrics. She has completed her Master’s degree at Hacettepe University in 2015. She is currently pursuing PhD degree about medical diseases nursing in same university.
Abstract:
Delirium, as an acute state of confusion, is a severe geriatric syndrome common among older patients in the intensive care unit (ICU). Delirium occurs at a high incidence in patients with ventilation support. Delirium incidence differs as to the type of ventilation support. Although its incidence in patients with NIMV is 20%-50%, in patients with IMV this ratio is 60%-80%. Among elderly populations, the incidence is also high. Although delirium screening is important, it does not ensure an improvement in health outcomes. Therefore, the clinical guidelines recommend early mobility to prevent delirium. Early mobility prevents complications of immobility by encouraging the patient to move and improve vital functions. Mobility has positive effects such as improving the venous return and stroke volume, increasing the amount of oxygen distributed to tissues, reducing ventilation time and enhancing cognitive abilities. Exercise is beneficial and highly recommended for patients to prevent delirium. According to our study which is mentioned in the title, the incidence of delirium was 8.5% in the intervention group (n=47) and 21.3% in the control group (n=47). Delirium incidence and duration decreased by 2.5-fold in the intervention group compared to the control group. So, this abstract aims to explain the effect of exercise to prevent delirium in geriatric patients.
Ozdemir Ozlem
Yıldırım Beyazıt University, Turkey
Title: Investigation of Efficacy of Home Visits That Compliance Drug Treatment for Elderly Individuals with Diabetes and Hypertension
Time : 10:20-10:40
Biography:
Özlem Özdemir has completed her PhD from Gülhane Military Medical Academy and Post-doctoral studies from Yildirim Beyazıt University Department of Nursing. She has published 6 papers in reputed journals and serving as an Editorial Board Member of Journal of Behavioral Health.
Abstract:
This front-end measurement quasi-experimental study evaluated drug compliance and the effectiveness of home visits to increase drug compliance in elderly individuals with diabetes and hypertension. The study was conducted between September 2012 and March 2013 at the homes of elderly people followed at the Ankara Gülhane Military Medical Academy Geriatric Outpatients and living in the city center. The sample of the study consisted of elderly individuals with diabetes and hypertension, followed up at the Geriatric Outpatients and meeting study inclusion criteria (n=45). Evaluation to determine the pre-implementation compliance of elderly people was performed at the beginning of the first home visit and the measurement to evaluate the effectiveness of the first home visit was performed prior to the second home visit. The data were collected with the data collection form prepared in accordance with the literature, a form to determine drug use status in the elderly, and the Medication Adherence Self-Efficacy Scale-Short Form. The data were analyzed by using the relevant tests in the SPSS 15.0 statistical software. The drug compliance of elderly individuals and their knowledge on the names of the drugs and what needs be considered related to drugs increased after the training at the first home visit. Therefore, training by a nurse at a home visit was found to be effective in increasing drug compliance of elderly people. According to these results, we suggest that home visits should be performed for the elderly to improve drug compliance, nurses should play an active role in these home visits and the necessary arrangements should be made within the current health care organization.
Sema Kocasli
Yıldırım Beyazıt University, Turkey
Title: Physical and psychosocial recovery patterns of patients after open heart surgery
Time : 10:40-11:00
Biography:
Sema KoçaÅŸlı has completed her PhD from Ä°stanbul University and Post-doctoral studies from Yildirim Beyazıt University Department of Nursing. She has published 2 papers in reputed journals and 4 chapters written in the different books.
Abstract:
This study was carried out as a descriptive-correlational type research to determine physical and psychosocial recovery conditions of patients after open heart surgery and to gain our country a measurement scale which will be used for this evaluation. The research was done in Dr. Siyami Hersek Thoracic and Cardiovascular Surgery Training and Research Hospital between March – July 2010 with 691 patients using patient identification form and Sickness Impact Profile-SIP 68. SIP 68’s Cronbach α reliability co-efficient was found to be µ=0.92 for the whole scale. It was also determined that reliability co-efficient of three sub-dimensions were between r=0.62 and 0.97 and in positive direction (p<0.001), reliability co-efficient of emotional stability of subgroups was low (r=0.16), reliability co-efficient of the other five subgroups were between r=0.51 and 0.97, in the positive direction and statistically highly meaningful. Of the patients participating in the research, 72.6% were male, 56% were between the ages 49-69, 75.3% were taken coronary artery bypass grafting and 99.4% of them had taken support from their family and relatives during their illness. It is determined that age, sex, smoking condition, body mass index, sport routines, support from family relations, which are between demographic characteristics, affected patients’ physical, social/psychological and cognitive/sexual behaviors. As a result, SIP 68 was found as an unsuitable scale for Turkey and inappropriate for physical, psychosocial healing of patients in the first periods after discharge.
Betul Tosun
Gulhane Military Medical Academy, Turkey
Title: Nursing Care of a Patient with Osteogenesis Imperfecta in Accordance with Kolcaba’s Comfort Model: Case Study
Time : 11:20-11:40
Biography:
Betül Tosun has completed her PhD in Nursing from Gülhane Military Medical Academy, School of Nursing, Department of Fundamentals of Nursing. She is working as a Lecturer at Gülhane Military Medical Academy, School of Nursing, Department of Fundamentals of Nursing. She has published 7 papers in reputed journals.
Abstract:
Aim: Comfort Theory, which defines comfort as state of absence of pain, anxiety, distress, uneasiness, was presented by Katharine Kolcaba in 1994. Kolcaba presented taxonomy for comfort comprised of 3 types (relief, ease and transcendence) and 4 dimensions (physical, psychospiritual, environmental and sociocultural). Osteogenesis Imperfecta (OI), known as fragile bone disease, is the most common genetic bone disease that deteriorates life comfort of patients from the early years of life. The aim of this case study was to test the applicability of Kolcaba’s Comfort Model in nursing care of a patient with OI. Methods: Nursing care of a patient with OI was planned and executed in accordance with Kolcaba’s Comfort Model and the outcomes were assessed in this case study. Case: Female, 13 years old patient with OI, who had heart shaped face, short stature and scoliosis, was hospitalized for right femur fracture. OI was diagnosed one month after the birth and she was able to walk at 18th month. Mobility was limited by time as she often experienced multiple fractures. The patient had experienced 3-6 fractures per year and was not able to walk when she had femur fracture at age 11. The child who was well informed about her disease and had developed self-protection behaviors, was easy to communicate and displayed proper reaction and affect. She was educated at home by visiting teachers, she did not get out of the house when she was not hospitalized and she spent most of her time with her family and friends at home. She was fed with mashed food instead of solid food because she lost her teeth at early ages. Patient was living with her mother and sister, and had no psychological support. Within the context of physical comfort; pain, frequent fractures and bone deformity due to decreased bone strength, difficulty in feeding due to loss of teeth was observed. Within the context of physical comfort; it was assessed that the family was inadequately informed about environmental setting reorganization. It was observed that the patient was not using wheelchair, spending most of her time at home and was shown around in a stroller. It was determined that this condition deteriorated the sociocultural comfort of the patient and leaded to social isolation. It was determined that the patient had no support for psychospiritual support but her mother had support for psychospiritual needs. The problems determined within the 4 dimensions of Comfort Model were solved with nursing activities planned according to 3 types of comfort. It was appreciated that physical, psychospiritual, environmental and sociocultural comfort of the patient and the family were promoted. Conclusion: We suggest that nursing care of patients with OI, planned in accordance with Comfort Model may reduce negative experiences of patients and their families. This study may give guidance to nurses who care for orthopedics and traumatology patients.
Nursemin Unal
Gulhane Military Medical Academy, Turkey
Title: Effects Of Planned And Unplanned Orthopedics Operations On The Patients’ Self- Esteem, Body Image And State Anxiety
Time : 11:40-12:00
Biography:
Nursemin Ünal has completed her Master’s degree in Nursing from Gazi University Medical Sciences Institute Department of Psychiatric Nursing and currenty she is a PhD student in Gülhane Military Medical Academy, School of Nursing, Department of Fundamentals of Nursing. In addition, she is working in Gulhane Military Medical Academy Department of Orthopedics and Traumatology as a Education and Training Nurse.
Abstract:
This study was planned to observe the effects of planned and unplanned orthopedic operations on the patients’ self- esteem, body image and state anxiety. The required permission was taken from the hospital where the study was done. The universe of this study was composed of 104 patients who had operations between March 1st, 2013 and October 31st, 2013 at Gulhane Military Medical Academy Orthopedics and Traumatology Service. The sample of this study consisted of 80 patients who accepted to join the study. The data was collected by using Patient Information Form, State Trait Anxiety Inventory, Coopersmith Self- Esteem Inventory and Body Cathexis Scale. The patients who had completed Patient Information Form and State Trait Anxiety Inventory before the operation, were given Coopersmith Self- Esteem Inventory, Body Cathexis Scale, State Trait Anxiety Inventory on the first day after the operation and they were given State Trait Anxiety Inventory again before discharge. SPSS 15 package program was used in evaluating the data. In the analysis of the data, Mann-Whitney U test and Friedman test were used and the statistical significance value was accepted as p<0.05. Bonferroni corrected Wilcoxon test was used and the statistical significance value was accepted as p<0.017. In Pearson Correlation test r<0.24 was accepted as weak correlation, 0.25-0.69 was accepted as moderate correlation and ≥0.70 was accepted as good correlation. The 62.5% of the participants were over 65 years old. The vast majority of the participants were women (76.3%) and married (63.8%). The education level of the majority of the participants was elementary school or below elementary school (76.3%) and only 12.5 % of them were working. Finally, the level of trait anxiety of young people before surgery was found high compared to old people. The level of trait anxiety of single people was also found high compared to married people. The anxiety level of the patients who received emergent surgery was found to be higher than the patients who received planned surgery. A positive relation was found between self-esteem and body image. In the light of the results obtained from the study, taking care of patients in a holistic way is suggested. It is also recommended to cooperate with consultation liaison psychiatry unit and generalize consultation liaison psychiatry nursing.
Hatice Simsek
Ege University, Turkey
Title: Last grade nursing and midwifery student recognition levels signs of violence against women
Time : 12:00-12:20
Biography:
Simsek Hatice has completed her Masters in 2011 from the Istanbul University, Public Health Department. She became a Research Assistant in the same year at Celal Bayar University. She is currently a PhD student and Research Assistant at Ege University Nursing Faculty, Department of Public Health Nursing.
Abstract:
This study was conducted to determine the level of recognition of signs of violence against women by nursing and midwifery students which will be the future of health care professionals. Ege University Faculty of Nursing and Celal Bayar University School of Health Sciences Nursing and Midwifery students were constituted the universe of descriptive study (n=557) and purposive sampling was used in the research. The sample of the study include nursing and midwifery students who are studying 4th year and agreed to participate as volunteers between September 2015-November 2015 (n=443). Survey participation rate was 80%. The research data were collected with “Descriptive Characteristics Form and Nurses†and “Midwives to Recognizing Symptoms Related to Violence Against Women Scale Formâ€. To conduct the study, application permission from the ethics committees and institutions has been taken and verbal consent was obtained from nursing and midwifery students. To assess the results, SPSS statistical analysis (Statistical Package for Social Sciences) was used for Windows 21.0 program. The average age of students was 22.22±1.50 (min:20-maks:35) (n:443) and 86.0% of the students were male and 14.0% were female. 74.7% of nursing and 25.3% of the midwifery section of students were educated about the issue. 94.6% of the students had information about violence against women; 80.4% of students found enough themselves diagnosing the symptoms of violence against women; 41.3% have received training on violence; 23.5% of the trainees was found with partially sufficient education. It was determined that 24.4% of the students were exposed to violence and who exposed to violence faced more emotional violence. Students rated physical symptoms subscale as 8.35±1.65 points and emotional symptoms subscale as 11.97±2.19 points. It was determined as 20.32±3.14 was the average total score of the scale. When the obtained results are evaluated, students' knowledge in recognizing the signs of domestic violence against women was found to be partially sufficient. The age, sex, nursing department, exposure to violence, receiving training about violence, status notification to violence of the students between the sub-dimensions and scale total score was with statistically significant difference (p<0.05). Diagnostic levels of signs of violence against women of students were partially sufficient. The findings suggested undergraduate training for nurses and midwives and planning of in-service training after graduation. So nurses and midwives will be able to perform interventions in earlier stages related to the prevention of violence against women.
Nkechi M Enwerem
Howard University, USA
Title: Knowledge, attitudes and awareness of food and drug interactions among nurses with different levels of experience
Time : 12:20-12:40
Biography:
Nkechi M Enwerem is an Assistant Professor in the Department of Nursing, Howard University. She has a Master’s degree in Nursing (University of Maryland), PhD in Medicinal Chemistry (University of Ibadan, Nigeria), and Post-doctoral training, developing methods for the analysis of drugs using HPLC in the school of Pharmacy, Howard University. She has over 25 publications in the area of Chemistry, Medicinal Plants and Nursing. She served as a Program Director of United Nations Development Program: medicinal and aromatic plants project in National Institute of Pharmaceutical Research and Drug Development (NIPRD), Abuja, Nigeria, between 1995 and 2000.
Abstract:
Background: The 2004 Institute of Medicine report (IOM), “Keeping Patients Safe,†recognized that the nursing profession is playing a critical role in patient safety. Although new nurses possess a strong theoretical knowledge of nursing, experience from practice is important in providing a safer level of practice. The retention of experienced nurses in practice would require a continuous, career-long learning. Medical errors resulting in Adverse Drug Reactions (ADRs), pose a significant public health problem. Studies on the knowledge, attitudes and awareness of FDI among nurses with different levels of experience are lacking. Aim: To examine the knowledge, attitudes and awareness of food and drug interactions (FDI) among nurses with different levels of experience in their day to day practices. Methods: This was a cross sectional study which included a structured questionnaire. The study included a convenience sample of 278 nurses divided into 5 groups with different levels of experience: 0-4 years (66); 5-9 years (75); 10-14 years (45); 15-19 years (41); and ≥20 years. Results: There was statistical difference in knowledge and attitude to FDI among the 5 groups. 72.3% of nurses had not observed food and drug interaction during their practice. Conclusion: The five groups all scored low in their knowledge of FDI. Most of the participants recommended in-house training on FDI every six (6) months. There is a significant difference in the knowledge of FDI among the five groups with different levels of nursing experience.
Priscilla O Okunji
Howard University, USA
Title: Urban teaching hospital patients’ outcomes: A comparative study
Time : 12:40-13:00
Biography:
Priscilla O Okunji is an Assistant Professor at Division of Nursing, Howard University, USA. She has obtained her Baccalaureate and Master’s degree in Nursing and Informatics respectively from University of Maryland. In addition, she has earned her Health Sciences Doctoral degree with concentration in International Health Educator/Researcher. She has been board certified in ANCC Medical Surgical Nursing since 2010. She is a recipient of several awards and often been invited to deliver podium presentation at both national and international conferences. She has published in peer reviewed journals and she is also a Principal Investigator of intramural grants/projects.
Abstract:
Patients with type-2 diabetes reportedly have different outcomes on discharge, according to hospital characteristics. In the present study, we evaluated the differences in the outcomes of diabetic patients admitted to a Minority Large Urban Teaching (MLUT) Hospital in 2012. Sample of 2,311 subjects diagnosed of type-2 diabetes (2,185) with comorbidities of myocardial infarction (77) and diabetic myocardial infarction (49) were extracted from the emergency room dataset of a Minority Large Urban Teaching, private and non-profit Hospital using the International Classification Data, ICD 9 codes 25000. The result of the study showed that more females (15%) were admitted than their male counterparts with 42.2% males and 57.8% females, 2.2% white and 97.8% black. For age distribution, the MLUT Hospital had more age groups (40-59 years) and (60-79 years) admitted than those with age less than 40 years and 80 years or older group. A significant difference (~32%) of patients admitted with income ($1.00-$38,999.00) and ($39,000.00-47,999.00$) was observed while patients with income ($48,000.00-$62,000.00) range were admitted more (~49%) in the MLUT than any other age group. For the outcomes, patient mortality rate was significant when compared to those that did not die in the hospital. However, a difference (~5%) was noted for hospital stay of 3 days when compared to other hospital stay categories. A significance difference (36.9%) was noted for patients with hospital charges of less than $20,000.00 and $80,000.00 or more. The overall outcomes showed that the mortality rates for patients who died in the hospital were not significant and most patients stayed more than 3 days on admission. However, majority of the patients were either charged less or more. This study is to be replicated with a higher level of analytics to ascertain the impact of the variables on the outcomes for a more validated result.
Michelle Ollivierre-Lawrence
City College School of Nursing Fort Lauderdale, USA
Title: Transitioning novice nurses in today’s health care world
Time : 13:45-14:05
Biography:
Michelle Ollivierre –Lawrence is a RN for over 10 years with vast areas of experience. She received her MSN from University of Phoenix, BSN from University of Miami and is currently a DNP candidate (completion date 12/2016) at Capella University. She has been a Nurse Educator for 8 years and at current college, lectures, coordinate clinical experiences for undergraduate nursing students, assist with NCLEX passing for graduates and placement in health care organizations. She has been a Director of more than three nursing programs, serves as a community liaison for new nurses in hospital settings. Her current project focuses at the decreasing incidence of medication errors in novice nurses by adopting the transition to practice module developed by the NCSBN.
Abstract:
The Institute of Medicine (2010) focused on nursing report identifies that the shortage of well-prepared nurses have an impact on the population. This report also discusses that there will be an increased need of well-prepared nurses in the near future because of the increase in population, more chronic illness, among other things. IOM discusses 2 main suggestions to assist the nursing workforce in gaining well prepared nurses. First suggestion is to increase the numbers of BSN (Bachelor of Science in Nursing) nurses by 80% by 2020. Second, offer nursing residencies that assist new nurses for easier transition into the nursing workforce. There are recommendations from agencies such as AACN and NCSBN on how these initiatives can be implemented. There is extensive evidence on the positive and negative impacts of both of these initiatives identified above. However, the first initiative is coexistent of the second. This is because, nurse residency programs that assist new nurse’s transition to nursing workforce are developed based on evidence based research involving BSN prepared nurses. In fact, the AACN has certification status for post baccalaureate RN residency programs and not associate degree RN residency programs. This paper will discuss the need for academic progression from associate degree nursing to BSN nursing which will then allow the increase in development of standardized nurse residency programs for BSN prepared nurses.
Creso Machado Lopes
Federal University of Acre, Brazil
Title: The health strategy of the family and nurse holding: Prospects and challenges
Time : 14:05-14:25
Biography:
Creso Machado Lopes has completed his PhD at the University of São Paulo and Postdoctoral studies at the Nursing Course at the University of Valladolid, Spain in 2015. He is a Professor of Research Methodology in Nursing and Nursing Surgical Center and he has published three books and has 28 published articles. He is a Leader of the research group and he was also the Vice-Coordinator of the Master's degree in Public Health, Deputy Director of Health and Sport Sciences Center and he is currently Assistant Professor Advisor.
Abstract:
Descriptive and bibliographical study, with the goal of raising literature on the Family Health Strategy and the Nurse Practice, focusing on the Prospects and Challenges within the Brazilian context. The Unified Health System was implemented in 1988, representing a movement of organized civil society, the movement for health reform, scientific societies, technicians, researchers, popular participation, governments, still relying on the results of the 8th National Conference Health, and is in line with the Primary Health Care, the World Health Organization. In turn, with the implementation of the National Primary Care Policy, there were several health actions at the individual and collective, including the Family Health Strategy, with broader assignment to develop a multidisciplinary work in health units, to break the fragmented care of human beings, meet in full with the participation of the individual, family and community and with the inclusion of shares in the physical and social environment, expanding access and health care. This is implemented by a multidisciplinary team, with the maximum 4,000 people, the average recommended 3,000 belonging to a defined urban-rural geographic area, where they developed the basic programs defined by the Ministry of Health, aimed at promoting health, prevention, diagnosis, recovery, control of the most frequent diseases and community health maintenance. For nurses to act in this strategy, the trainer body should set your profile, form professional questioning, participatory, apply the knowledge for the community, to break with the biomedical model, change the hospital-centered vision and medicalization of disease, emphasis in public health including individual, family and community, and meet the other members of the healthcare team for a humane and holistic action. To the prospects and challenges, there is a lack of investment in comprehensive care, need to expand the number of teams, problems in infrastructure, poor working conditions, lack of medicines and supplies, high turnover of staff, concerned managers with quantification of services, policy decision by the manager, difficulties in reference and counter reference, promote the process of continuous and permanent education, academic education that considers the family as the center of care, reconciliation of working hours and training, lack of training in management, low number of nurses with a specialization course, salary dissatisfaction by nurses to comply with more hours and receive lower wages than the doctor, the above number of families to be met, activity overload, lack of time for planning, multi-role, lack of vehicle in drive to transport users, lack of professionals in the health and safety of staff in the unit. Because the nurses and staff working alongside communities in a constant state of vulnerability, by socioeconomic and cultural conditions, and is included in this context, teenagers and even young adults, and given the current international situations and national force as the issue of changes climate overall, water scarcity, intense migratory movements, religious conflicts, wars, risk of terrorist practices, attacks, youth grooming to integrate these moves, alcohol and drugs, violence, among others, that may affect this population. It is of fundamental importance that professionals in the family health team keep up to date and able to include in their actions these specific topics aimed at prevention and promotion of healthy citizenship. Thus, it is concluded that the Family Health Strategy is still under implementation and adaptation, but that strides to achieve success and culminate to the promotion of family health for its individual and collective, thus corroborating achieving the principles and guidelines.
Teresa V. Hurley
Mount Saint Mary College School of Nursing, USA
Title: Making a Difference in Healthcare Outcomes: Facilitating Evidenced-based Projects by Nurse and Family Nurse Practitioner Students
Time : 14:25-14:55
Biography:
Teresa V Hurley has completed her MS from City University of New York 1987 and her DHEd from A T Still University in 2011. Currently she is teaching all graduate nurse practitioner research courses. She is a quantitative, qualitative and mixed-method Researcher focusing on experiential teaching strategies, academic success predictors, financial and academic effects of remediation and course repeats and qualities sought in new hires. She has presented to international audiences and is a published author including co-chaptering transcultural concepts integration in foundation all nursing courses.
Abstract:
The driving forces in healthcare delivery are quality patient care outcomes, patient satisfaction, and cost-effectiveness. Resolution of issues or problems is these areas, are contingent on nurses understanding the role of research in supporting their practice decisions. Exposure to evidenced-based practice typically occurs in academic settings at the undergraduate level; undertaking research occurs at the graduate level, where nurse educators are in a prime position to facilitate the utilization of research in varied practice settings using experiential and constructivist teaching/learning strategies. At Mount Saint Mary College, graduate students enrolled in the nurse or the family nurse practitioner program is making profound changes in healthcare. Their evidenced-based projects are from birth through dying that requires administrative support and inter-professional collaboration Projects occur in acute care, educational (K-6 grades), nursing homes, military, clinics, group and private practice settings, projects examples are maternal laboring down, kangaroo care, pre-operative warming; fall reduction, hand hygiene compliance, tobacco cessation, pain assessment and re-assessment; adolescent suicide risk assessment, pre-colonoscopy stress reduction and anxiety; reduction in CHF re-admissions; antibiotic compliance; hepatitis C viral load reductions; decrease urinary catheter use and infections, pressure ulcer reduction, Intervention examples included traditional educational approaches, simulation, videography, telephonic follow-up, inter-professional coaching and complementary and alternative modalities as lavender and Yoga. These interventions obtained from research and applied to specific problems and issues, the graduate students identified resulted in positive outcomes and policy changes. The prime focus of the nurse educator is to tap into the students’ passion and provide positive and frequent formative feedback.
Helen Donovan
Central Queensland University, Australia
Title: Overburdening Families at a time of Graduate Vulnerability
Biography:
Helen Donovan is a Lecturer in Nursing at the Queensland University of Technology in Brisbane, Australia. She has a strong interest in professional practice and particularly the transition to practice experiences of graduate nurses and midwives. This paper draws from her PhD studies of double degree graduate nurse midwife transition experiences which included participants working in Australian rural, regional and metropolitan areas of practice.
Abstract:
Background: The graduate year for novice registered nurses and midwives is known to be a time of anxiety and excitement punctuated with ‘highs and lows’ directly related to changing workloads, increased responsibility and staff dynamics. The need for professional support during this time has been well documented. The graduate demands on family and friends at this challenging time has however been rarely examined. Method: This descriptive phenomenological study explored the experiences of 23 Australian double degree (Bachelor of Nursing/Bachelor of Midwifery) graduates in their 1st year of practice. Individual face to face interviews conducted between 9-12 months of the participant’s commencing employment provided an opportunity to understand both the professional and personal support needs of these graduate nurses and midwives during their year of transition to registered nurse midwife practice. Findings: The findings showed that all participants in this study needed more support than that which was provided in the clinical environment. This was most evident in the first 3 months of practice where detailed sharing of experiences via daily phone calls, emails, social networking and face to face debriefing with family and friends was regarded by the participants to be essential for them to cope with the intrinsic and extrinsic expectations of their new role. Debriefing with family and friends who worked and understood the health care industry was regarded to be the most valuable, as support could be practice focused if necessary. Conclusion: Graduate nurses and midwives look externally to family and friends for support when the clinical environment does not meet their beginner needs. As a result, family and friends are at risk of becoming overburdened by: Graduate demands for counseling and advice; being exposed to confidential information while having no support systems themselves from which to draw. The need for clinical facilities to provide adequate support systems for the beginning nurse midwife is essential to ensure that families and friends are not forced into a role of professional mentor and mediator.
Biography:
Hossam Ibrahim Eldesuky Ali Hassan has completed his MD from Zagazig University Egypt, Faculty of Medicine, Anesthesia and Critical Care Department, Egypt. He is the Director of AICU Department in King Salman Military Hospital, Tabouk, Saudi Arabia and Associated Professor in the Faculty of Medicine, Zagazig University, Egypt. He has published more than 12 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Objectives: The study was conducted to compare 2 techniques of moderate sedation for patients undergoing ERCP, using either dexmedetomidine or ketofol as regards to hemodynamic, sedation, pain, respiratory effect, recovery time, patients’ and endoscopists’ satisfactions, and complications during and after the procedure. Patients & Methods: Fifty patients were randomly allocated in one of two groups; dexmedetomidine group D (n=25) received 1 lg/kg i.v. bolus over 10 min followed by 0.5 lg/kg/h or ketamine/propofol (ketofol) group KP (n=25) received 1 mg/kg i.v. bolus followed by 50 lg/kg/min. The level of sedation was adjusted to achieve a Ramsay sedation scale (RSS) score of 4 in both groups of patients. Mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SPO2), and facial pain score (FPS) were compared. Time to achieve RSS, modified Aldrete’s score (MAS) of 9–10 and the related complications were compared between groups. Patients’ and endoscopists’ satisfactions were compared. Total amount of rescue sedation was recorded. Results: After loading dose HR and MAP were significantly lower in group D as compared with group KP (p<0.05). HR was significantly lower in group D during the recovery (p<0.05). No significant difference between both groups as regards to time to achieve RSS, MAS, FPS and total dose of rescue sedation. Personnel restraint was significantly lower in group KP (8% versus 20%) than in group D. Endoscopists’ satisfaction was significantly higher in group KP than D group (92% and 80%) respectively. Conclusion: Ketofol (1:1) provided better hemodynamic stability than dexmedetomidine and standard alternative to it in moderate sedation during ERCP.
Biography:
Hamdan Mohammad Albaqawi has completed his PhD from RMIT University School of Nursing and Midwifery in Australia. Currently he is working in the University of Hail as an Assistant Professor and the Vice Dean of the Academic Affairs in the College of Nursing. He has worked in many hospitals in Saudi Arabia and attended many courses and participated in many international conferences.
Abstract:
The study aims to determine relationship between the level of awareness of the ICU staff nurses on holistic care approach and the level of their nursing competencies. The study will utilize a quantitative, descriptive, correlational design. Frequency distribution, weighted mean, percentage, ANOVA and Pearson product moment of correlation will be employed for statistical treatments. This study will be conducted in four different hospitals in Ha’il city. Purposive sampling will be utilized in the selection of the respondents. The researcher will administer a researcher-made instrument for determining the level of awareness of the ICU staff nurses on holistic care approach. The researcher will utilize secondary data in the form of a copy of the competency evaluation tool, utilized by the nursing service and issued by Ministry of Health to determine the level of competency of ICU staff nurses. The results of the study can be utilized by the nursing service to develop a quality patient care program and unit-specific caring enhancement plans for ICU staff nurses.
Burcu Arkan
Uludag University School of Health, Turkey
Title: The Impact of Positive Parenting Programs (Triple P) on Family Mental Health with Turkish Parents
Biography:
Burcu Arkan has completed her Bachelor’s degree in Dokuz Eylul University, Faculty of Nursing in 2004, Master’s degree and PhD from Dokuz Eylül University, Institute of Health Sciences. She also had additional training in child and adolescent psychiatry in Queensland University, Australia. She participated in Triple P Provider Training Courses in Australia. She has been conducting Triple P with parents in Turkey. She teaches psychiatric nursing, child and adolescent mental health nursing and coping with stress. She conducts research in the area of parenting and family psychology. She has several textbook chapters, national and international articles published in mental health journals.
Abstract:
Triple P- Positive Parenting Programme features strong collaboration between family and community, decreases risk factors, increases preventive factors, with a multidisciplinary approach and has compiled a strong eveidence base where randomised controlled research models were used and long time follow-up outcomes gathered. Triple P- Positive Parenting Programme was developed at the University of Queensland Parenting and Family Support Center started in 1979 and is now actively implemented in 25 countries. Triple P is a multi-level family intervention programme developed for the parents of children and adolescents that have or are at risk for behavioral problems. The programme is particularly helpful for the parents of children who have persistent, rebellious, defiant, aggressive and in general, distressing behavior. In randomised controlled trials, strong evidence was reported regarding the efficiency of various Triple P preventive and clinical interventions. Evidence across a range of different levels of the intervention indicates a decrease in problematic behavior of the parents’ children, and dysfunctional parenting practice of parents (neglect, talking too much, overreacting), an increase in positive parenting practice of the parents, feeling satisfied as a parent, an increase in the level of efficient parenting and parents’ overall trust, attachment and interest levels, and a decrease in the levels of stress and depression of parents.
Seyed Mohammadreza Hashemian
Masih Daneshvari Hospital, Iran
Title: Radiologic manifestations of pulmonary tuberculosis in patients of intensive care units
Biography:
Seyed Mohammadreza Hashemian is an Assistant Professor at Shahid Beheshti University of Medical Sciences, Iran.
Abstract:
Tuberculosis (TB) is a serpent disease with various pulmonary manifestations, and timely diagnosis of the disease is paramount, since delayed treatment is associated with severe morbidity, particularly in intensive care units (ICU). Therefore, it is imperative that intensivists understand the typical distribution, patterns, and imaging manifestations of TB. This study was conducted to describe different manifestations of pulmonary TB in patients in the ICU. In this retrospective study, all patients with a clinical and a laboratory-confirmed diagnosis of TB who were admitted to the ICU were involved the study. All patients had a confirmatory laboratory diagnosis of TB including positive smears. The patterns of parenchymal lesions, involved segments and presence of cavity, bronchiectasis and bronchogenic spread of the lesions with computed tomography (CT) and chest/X-ray (CXR) were recorded and analyzed. Data of 146 patients with TB were entered in the study. The most common finding in CT was acute respiratory distress syndrome (ARDS) like radiologic manifestations (17.1%), followed by parenchymal nodular infiltration (13.6%) and cavitation (10.9%), consolidation (10.2%), interstitial involvement (9.5%), calcified parenchymal mass (8.3%), ground-glass opacities (7.5%), and pleural effusion or thickening (6.9%). Radiologic evidence of lymphadenopathy was seen in up to 43% of adults. Miliary TB was observed in 2.3% of patients, mostly in those older than 60 years of age. ARDS like (64.5%) manifestations on CT and miliary TB (85.5%) had the highest mortality rates among other pulmonary manifestations. ARDS, interstitial involvement, and parenchymal nodular infiltration are the most common manifestations of pulmonary TB. Various features of TB in ICU patients could be misleading for intensivists.
Biography:
Lu Xing is a student of Master of Nursing Specialist (MNS) from West China School of Medicine/ West China Hospital of Sichuan University. Her research area of interest is Clinical Care and she had already done some researches and written some papers about clinical nursing and nursing education, especially about patients’ quality of life after discharge.
Abstract:
Objective: To discuss the current situation of abdominal surgery patients’ readiness for hospital discharge, compare the discrepancy between patients’ self-appraisal, nurses’ evaluation and family members’ self-appraisal, and provide evidence to improve patients’ quality of life after discharge. Methods: A convenience sample of 239 patients, 74 nurses and 239 family members were selected according to the criterions. Four instruments were used to collect data: General Data Scale, the Chinese version of the Readiness for Hospital Discharge Scale (RHDS-C), the Readiness for Hospital Discharge Scale of Family, the Registered Nurses’ Perception of Readiness for Hospital Discharge Scale (RNRHDS). Results: The score of RHDS-C was (159.94±37.61), the scores of subscales in descending order were: expected support, coping ability, knowledge and personal status. Nurses’ evaluation score and family members’ self-appraisal score of readiness for hospital discharge were (167.93±26.71) and (166.49±36.17) respectively, they both had statistically significant difference with patients’ self-appraisal (t=-3.192, P=0.002, t=-3.444, P=0.001). Conclusion: Abdominal surgery patients’ readiness for hospital discharge was above average, nurses overestimated patients’ readiness for hospital discharge, and readiness for hospital discharge of family members’ and patients’ self-appraisal were different. Therefore, medical workers should add patients’ self-assessment to the evaluation system of readiness for hospital discharge to evaluate more objectively and accurately, and actively carry out patient-centered discharge planning services. In addition, medical workers should pay attention to the family members’ readiness for hospital discharge at the same time and give them individualized discharge guidance. Thus it can improve the patients’ rehabilitation effectiveness and quality of life after discharge ultimately.
Biography:
Alvisa Palese has been attending the Doctoral Program of the Hull University. She is an Associate Professor at Udine University School of Nursing. She has published more than 170 papers in reputed journal and has been serving as an Editorial Board Member of Assistenza Infermieristica e Ricerca, the only Italian scientific nursing journal indexed in the MedLine database and with impact factor.
Abstract:
Informal caregiving, intended as the presence of family members, friends or other lay caregivers providing care at the patient’s bedside, has been widely recommended for its important emotional and social impact, and for its contribution to basic care. With the increased frailty of patients admitted into hospital and the current economic crisis, which may have increased the amount of needed care and reduced the hospital nursing staff, there is a need to update the knowledge available on in-hospital informal care. The aim of this longitudinal study was to describe the individual and organizational predictors of the amount of informal care received by patients admitted into 12 acute medical units in the Northern Italy. The 77.1% of the included patients (N=1,464) received at least one shift of informal care during their in-hospital stay, especially during the mornings and afternoons. At the patient level, those at higher risk of prolonged hospitalization and difficult discharge on admission (b=0.119, 95% CI 0.035-0.203) and those reporting higher occurrence of negative outcomes, such as pressure sores (b=1.508, 95% CI 0.567-2.449), confusion events and use of physical restraints (b=0.532, 95% CI 0.370-0.695) during the hospitalization (b=0.182, 95% CI 0.027-0.337), were more likely to receive informal care. At the organizational level, a higher amount of missed nursing care (b=0.179, 95% CI 0.086-0.271), was associated with an increased number of informal care shifts. The results seem to suggest that families contribute substantially to the care of patients, especially of the frailer ones, and that try to compensate for organizational failures.
Ahmed M Nooh
Zagazig University, Egypt
Title: Nature and prevalence of menstrual disorders among teenage female students at Zagazig University, Zagazig, Egypt
Biography:
Ahmed M Nooh is an Egyptian/British qualified and trained Consultant Obstetrician & Gynaecologist with extensive experience in emergency and elective gynaecological surgery (laparoscopic, abdominal and vaginal). He qualified from Zagazig University in Egypt and further highly qualified both from Egypt (Master & Doctorate degrees) and the United Kingdom (Fellowship in gynaecological surgery from the Royal College of Surgeons of Edinburgh, Scotland and the British Board in Obstetrics & Gynaecology (CCST) from the Royal College of Obstetricians & Gynaecologists in London). He completed his advanced clinical training in Britain and Ireland. Dr Nooh is a member of the British Fertility Society, the British Society of Colposcopy and Cervical Pathology and the Egyptian Fertility & Sterility Society. He attended and actively participated in numerous international training courses and scientific meetings in laparoscopy, advanced vaginal surgery, assisted reproductive techniques, colposcopy and high risk pregnancy. Dr Nooh has been involved in the teaching programme for junior doctors and medical students of several teaching hospitals in Britain, Ireland and Egypt. He has a track record of research and publications in international peer-reviewed journals in the field of Obstetrics and Gynaecology.
Abstract:
Study Objective: To determine the nature and prevalence of menstrual disorders among teenage females. Design Setting: An observational descriptive cross-sectional study was conducted at Zagazig University Students’ Hospital, Zagazig, Egypt. Participants include a representative sample of female students attending the university pre-enrolment medical examination. Interventions: Self-administered questionnaire covering items on the adolescents’ demographic data and menstruation characteristics was used to collect the data. Main Outcome Measures: Information about menarche, body mass index (BMI), physical exercise, cycle length and regularity, duration of menses, menstrual blood loss, dysmenorrhea, and pre-menstrual syndrome (PMS). Results: A total of 285 questionnaires were analysed. Mean age at menarche was 12.3±1.5. Oligomenorrhea was reported by 18 participants (6.3%) while 5 others (1.8%) mentioned having polymenorrhea. Hypomenorrhea was noted in 25 students (8.8%), while hypermenorrhea was reported by 12 (4.2%). Irregular periods were mentioned by 24 students (8.4%). Dysmenorrhea was reported in 188 students (66.0%). Out of these, 81 (28.4%) graded their pain as mild, 69 (24.2%) as moderate and 38 (13.3%) as severe. PMS was mentioned by 160 girls (56.1%). Consulting somebody regarding their menstrual problems was reported by 36 students (12.6%). Conclusion: Our results are not greatly different from those in other parts of the world. Data on nature and prevalence of menstrual disorders and their impact on young women’s health status, quality of life and social integration suggest that management of these disorders should be given more attention within the available reproductive health care programs. Further research into prevalence of and risk factors for menstrual disorders and their morbidity is warranted and anxiously awaited.
Saima Hamid
Health Services Academy, Pakistan
Title: Ethical dilemmas faced by nurses in clinical practice in a district in Pakistan
Biography:
Saima Hamid started working at HSA as a Research Officer in 1998. In 2000, she was appointed as the Instructor through Public Service Commission. She completed her MSPH in 2001. She completed her PhD from Karolinska Institute, Sweden. She is currently working as Associate Professor and Registrar at Health Services Academy, Islamabad. She is also a visiting and adjunct faculty at the Karlinska Institute and Univeristy of the United Arab Emirates. She has published more than 25 papers in reputed journals and has been serving as the Chief Editor for the Pakistan Journal of Public Health.
Abstract:
As health care becomes complex, nurses encounter difficult ethical issues in clinical practice on daily basis. This study was designed to explore the ethical issues and gaps using the Pakistan Nursing Council’s ethical code framework. A qualitative study was undertaken. Six focus group discussions were done with nurses in six government hospitals of District Layyah, Pakistan. The qualitative data from all the FGDs was analysed by applying thematic analysis. Six themes for nurse’s ethical dilemmas identified were: compromised professional accountability to patient, uncooperative behaviour of peers and poor image of a nurse in society. Ambiguity and dilemmas concerning the professional codes of ethics, related to patient care, colleagues and oneself, were encountered more as compared with issues of resource allocation. Nurses reported that they were unable to act on the PNC code fully because of many constraints in clinical practice. The reasons identified by the respondents were complex administrative processes and mixed messages, poor image of the nursing profession, and a power imbalance in the workplace. It was concluded that nurses were not working according to their job description - it was because of lack of knowledge in some cases, while implementation of the established guidelines was problematic in others. Awareness among the nurses regarding PNC guidelines and further implementation of standardized rules is required on an urgent basis. This study provides evidence which will set the scene for the health managers to develop mechanisms to sensitize their staff towards ethical dilemmas they may potentially face in their clinical practice.
Kimberly A. Derico
Fairmont State University
Title: Making Informatics Come to Life Through Assessment: Linking assessment and documentation education in the classroom
Biography:
Kimberly Derico has completed her BSN from West Virginia University School of Nursing and MSN from Marshall University School of Nursing. She is an assistant professor of nursing in the ASN program at Fairmont State University in West Virginia, USA, where she teaches in the maternal-child I, II & III courses. She has practiced nursing for 21 years in the following clinical areas: Level I Trauma/Medical/Surgical ICU, Level IV NICU, PICU, Pediatrics, Obsterical and Community School Nursing. She has taught in both ASN and BSN programs for 7 years in the following course areas: Fundamentals, Pediatrics, Maternity, Maternal-Child and Simulation Lab Coordination.
Abstract:
Informatics, which is defined by QSEN as: Using information and technology to communicate, manage knowledge, mitigate error, and support decision making; is one of the core competencies for nursing set forth by the Institute of Medicine (IOM) and The Quality and Safety Education for Nurses (QSEN) faculty. One of the QSEN core skills linked to informatics is documenting and planning patient care in the electronic medical record (EMR), a skill that can be confusing to a beginning nursing student. Nursing students can also become easily confused when learning assessment skills in the classroom, but accurate assessment skills must be achieved in order to complete accurate documentation. When assessing a patient, distinquishing what the assessment findings are and what should be documented in the electronic EMR to clearly communicate the findings are special skills that are vital to the nursing role, communication among care team members and patient safety. Linking these two skills in a real-life, fun and innovative way in the classroom can make for better overall understanding of each skill and its importance to safe patient care.
Horathalge Nethnee Sanuri de Silva
National Hospital of Sri Lanka
Title: Attitudes of Nurses towards end-of-life care for themselves.
Biography:
Silva H N S D is currently an Undergraduate nursing student, who completed her Advanced Diploma in General nursing at the International Institute of General Nursing in Welisara, Sri Lanka, and is waiting to join the Murdoch University, Perth, Western Australia in-order to complete her Bachelor of Nursing degree.
Abstract:
Introduction: 88.3% of physicians decided to choose a “no-code†or a DNR order, if hospitalized and would choose to die less aggressively at home. But, their wishes were mostly over ridden. Objective: To assess the attitudes of nurses towards the end-of-the-life care, they would like to receive for themselves and their attitudes towards terminal illnesses. Methods: A mixed method approach was used. A closed and open ended questionnaire was administered to 73 participants and 5 registered nurses, who have more than 10 years of experience, working in hospitals both in Sri Lanka and abroad, were interviewed. Results: 94.1% of the participants stated that they would like to die at home, spending their last hours at home surrounded by their loved ones and engaging in religious activities but 57.7% of unmarried nurses said they would agree on euthanasia if they had a terminal disease, and also 66.2% of them stated they would agree in DNR order if they happen to be admitted to the ICU, but 82.5% wanted to diagnose if they had a terminal illness or cancer but did not agree on euthanasia. Qualitative analysis confirmed the findings and revealed that despite having adequate confidence about the hospital care, nurses would choose to die at home, surrounded by their loved ones and engaging in religious activities. Euthanasia was believed to be inappropriate as it is religiously incorrect and as death is a natural process. Conclusion: The perception of death among nurses depends on their religious belief.
Laila Akber Cassum
Aga Khan University, Pakistan
Title: Experiences of elderly people who are brought to live in shelter homes in Karachi, Pakistan
Biography:
Biography Laila Akber Cassum has recently graduated as a Master of Science in Nursing (MScN) from Aga Khan University School of Nursing and Midwifery (AKUSONAM), Karachi, Pakistan. She did her diploma in 1998 and Baccalaureate of Science in Nursing (Post RN BScN) in 2003 from the same institution. She has worked as a Critical Care Nurse (CCN) for 3 years in Cardiac Intensive Care Unit (CICU) from Aga Khan University Hospital (AKUH). Then, she pursued her career as a Nurse Educator in facilitating the coming generation of students in the field of Nursing. She has also worked in the domain of research in the capacity of Research Assistant and then as a Research Coordinator. She has completed her undergraduate nursing education with high
Abstract:
Objective: The study aimed to explore the experiences of the elderly people who are brought to live in shelter homes, in the context of Pakistan. It also aimed to identify the reasons which compelled the elderly people to reside in these shelter homes. Methodology: A qualitative methodology, with a descriptive exploratory design, was adopted for the study. In line with the pre-set inclusion criteria, a purposive sample of 14 elderly males and females were selected for the study, from two different shelter homes in Karachi, Pakistan. Data was collected through a semi-structured interview. The interviews were audio recorded and transcribed precisely. The data was coded, categorized manually, and analyzed using the guidelines given by Miles and Huberman (1994). Results: Content analysis of the data revealed 5 major themes: circumstances of leaving home, experiences, challenges, coping with challenges, and decision to live in a shelter home. The analysis revealed that the elderly were experiencing lack of physical, psychological, emotional, and financial support from their family and children. It also indicated that migration of children for better career and employment opportunities, entrance of women into the workforce, and insensitive behavior of children, left the senior citizens neglected and helpless. The findings also uncovered the challenges of unemployment and family disputes that the elderly had to face made them dependent, distressed, and helpless, resulting in both their apparently willing and forceful decision to reside in shelter homes. Conclusion: The study indicated the emerging notion of institutionalization of the elderly in Karachi, Pakistan. The findings point to need for further investigation of the identified areas in this study through qualitative and quantitative researches. There is a dire need for increasing public awareness through the social, electronic, and print media, and providing capacity building training to HCPs for the care of the elderly. The lobbying group can act as a catalyst in persuading the government officials for the execution of a policy on retirement, day care centers, and subsidized provision of health services for the betterment of the elderly.