International Journal of Nursing http://ijn.in/index.php/ijn <p><strong>The International Journal of Nursing (IJN)</strong> is a peer reviewed, open access nursing journal devoted to publishing research papers and scholarship about nursing education, health care delivery, organisation, management, workforce, policy and research methods relevant to nursing, midwifery and other health related professions. The IJN aims to provide an international forum for the exchange of ideas and findings from researchers across different cultures and encourages research on the impact of cultural factors on nursing theory and practice. It also seeks to promote the transfer of knowledge between professionals in academia and industry by emphasizing research in which results are of interest or applicable to nursing practices</p> Health Pro en-US International Journal of Nursing 2279-0195 <p>The Copyright Notice entered below will appear in About the Journal and in each published item's metadata. While it is up to the journal to determine the nature of its copyright agreement with authors, the Public Knowledge Project recommends the use of theÂ&nbsp;<a class="action" href="http://creativecommons.org/" target="_new">CREATIVE COMMONS</a> license. To that end, it providesÂ&nbsp;<a class="action" href="/index.php/ijn/information/sampleCopyrightWording" target="_new">SAMPLE COPYRIGHT NOTICE WORDING</a> that can be cut and pasted into the space below for journals that (a) offer open access, (b) offer delayed open access, or (c) do not offer open access.</p> Prevalence and correlates of hunger among private aided secondary school children in Bangalore http://ijn.in/index.php/ijn/article/view/282 <p>Background: Literacy is an indispensable minimum condition for development of India, but it is far from sufficient. The Gross Enrolment Ratio of class I to X is 94.4 per cent and the dropout rate is 52.8%. There are many reasons for school dropouts, Hunger plays a major role. Hence the present report focus on the prevalence and factors associated with hunger among private aided secondary school children in Bangalore. </p><p>Methods: This study involved secondary analysis of data from the PhD research project i.e. Effectiveness of Adolescent Health Education Programme on Health among adolescents, which was conducted from 2010 to 2015 at Bangalore, Karnataka, India to estimate the prevalence of  self-reported hunger within the last 30 days among primary and secondary school age group.</p><p>Results: Total of 204 students data were analysed. The overall prevalence of self reported hunger was 14.7%.  Results revealed that age, dietary pattern and use of soap for hand washing had significant association with hunger.  </p><p>Conclusion: Hunger among school children is an crucial public health issue in India, which in turn affect the literacy rate, productivity and overall growth of the nation. It is high time for the government and other stake holders to take necessary steps to eradicate hunger from world.</p><p> </p> G Balamurugan SS Prabhudeva ##submission.copyrightStatement## 2015-07-20 2015-07-20 4 1 67 69 State of the art of nursing approach to family in chronic condition in childhood in Brazil http://ijn.in/index.php/ijn/article/view/192 <p>The present study aimed to increase the knowledge about nursing approach to family in chronic condition in childhood, published in the national literature, and provide subsidies to work in assisting families. This is an integrative literature review with a view to characterizing the production of knowledge. The driving question was “How does Nursing assist the family experiencing chronic condition in childhood?”. The following keywords <em>Nursing</em>, <em>Family</em>, <em>Children</em> and <em>Chronic Condition</em> were used in the research in electronic databases. It was possible to identify the importance of nurses to families for health promotion.</p><p><strong>Key words: </strong>Pediatric nursing, Child, Family, Chronic Diseases</p> Fernanda Lise Viviane Marten Milbrath Eda Schwartz ##submission.copyrightStatement## 2015-06-23 2015-06-23 4 1 70 74 Concept Analysis: Just Culture http://ijn.in/index.php/ijn/article/view/177 <p><strong>Title: </strong>Concept Analysis: Just Culture</p><p><strong>Background: </strong>Traditionally, healthcare’s culture has held individuals accountable for all errors or mishaps that befall patients under their care. This punitive approach creates the culture of fear among practitioners that withheld information that is needed to identify faulty systems and create safer ones. As an alternative to this traditional system, application of a model which is widely used in aviation industry known as the Just Culture Model seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix the system issues (ANA, 2010).</p><p> </p><p><strong>Methods: </strong>This concept analysis that utilized the Walker and Avant method aims to (a) observe the basic elements of the concept under study i.e., defining attributes, antecedents, consequences and empirical referents; (b) develop an operational definition that is meaningful across different discipline and participants that can be easily understood and useful across research, policy and practice; and (c) highlight implications for research of the future.</p><p><strong>Results: </strong>Defining Attributes: According to this analysis, the occurrence of a just culture environment involves three main features which include (a) encouragement of error disclosure through open communication; (b) a well-established balanced accountability; and (c) a collaborative learning environment. These attributes reinforces the implicit claim of just culture that it is inevitable for practitioners to commit mistakes that even the most experienced individual is capable of making mistakes. It is also implied in just culture that punishment is not an assurance that workers will not be making mistakes and that perfecting a performance is impossible and can never be sustained.</p><p><strong>Conclusion:</strong>    Based on the attributes extracted by this concept analysis, just culture is hereby operationally defined as an environment that reflects a well-established balance accountability supporting collaborative learning that stems from the encouragement of error-disclosure attained through open communication. Having the concept operationally defined and despite the recognized importance of a just culture, not every healthcare institution has adopted this type of approach.</p><p> </p><p>Keyword: concept analysis, just culture, nursing practice, nursing education</p> Bernardo Oliber Jr Alconis Arde ##submission.copyrightStatement## 2015-06-23 2015-06-23 4 1 88 93 Chinese Tongue Cancer Survivors’ Perspectives One Year Post-Partial Glossectomy http://ijn.in/index.php/ijn/article/view/160 <p align="left"><strong>Background: </strong>Tongue cancer is the most common form of oral cancer globally.<strong> </strong>Treatment for tongue cancer has become more effective, but there are heavy functional and aesthetic sequelae that affect quality of life.  Assisting patients to attain a satisfactory quality of life post-operatively requires health care providers have an understanding of how these sequelae are perceived by the patients. Little is known about how people in China perceive and manage the sequelae of tongue cancer surgery.</p><p align="left"><strong>Objective: </strong>To understand how people in one province in China perceive and manage the sequelae of surgery for tongue cancer.</p><p align="left"><strong>Population:</strong> Sixteen participants from a provincial hospital in China who had partial glossectomy and free thigh flap reconstruction at a major Chinese cancer center were enrolled in the study. All were men.</p><p align="left"><strong>Methods: </strong>Semi-structured interviews were conducted with participants one year following their surgery.  Interviews were conducted and transcribed in Mandarin.  Analysis was conducted using modified content analysis techniques to identify and describe major categories.</p><p align="left"><strong>Interpretation: </strong>We identified several categories related to functional alterations, appearance changes, social impacts, and management of the sequelae.  These include changes in eating, speech, decreased shoulder mobility, facial appearance; the impact of these changes on social activities; and accommodations made such as use of Traditional Chinese Medicine and changes in eating patterns.</p><p><strong>Conclusions: </strong>The support of family and friends was important to the recovery process. Adaptations to the treatment sequelae allowed these participants to maintain adequate food intake, resume some daily activity, and manage discomfort. Physical therapy may alleviate shoulder weakness and numbness post-surgery.</p> Yanhui Zhou Yanqun Li Xiao Zhou Jianjun Yu Li Li Caiyun Ouyang Zan Li Mei Gu Elisabeth M. Hicks Sally L. Maliski ##submission.copyrightStatement## 2015-06-23 2015-06-23 4 1 34 43 A Qualitative Study Identifying Motivators, Facilitators, and Barriers to Tobacco Cessation in Older Adults http://ijn.in/index.php/ijn/article/view/187 <p><span style="font-size: medium;"><span style="font-family: Times New Roman;"><strong>Background: </strong>Tobacco use is the single largest preventable cause of premature death and disease in the world and in the United States and is associated with diseases of nearly every organ system.</span> <span style="font-family: Times New Roman;">Tobacco cessation is considered the single most important factor to improve the health of older adults who use tobacco. However, minimal research has focused on the process of tobacco cessation or factors influencing this process.</span></span></p><p><span style="font-size: medium;"><span style="font-family: Times New Roman;"><strong>Purpose:  </strong>This qualitative study aimed to identify motivators, facilitators, and barriers to tobacco cessation and prolonged cessation in older adults aged 50 years and older. </span></span></p><p><span style="font-size: medium;"><span style="font-family: Times New Roman;"><strong>Design and Methods: </strong>This qualitative research study explored tobacco cessation in community dwelling older adults after receiving Institutional Review Board approval. The Transtheoretical Model of Behavior Change was the conceptual framework used to guide this study. Snowball sampling was used to recruit 20 older adults who had ceased using tobacco products for one year or more and remained tobacco free. Semi-structured audio-recorded interviews were conducted in each participant’s home.  Data were analyzed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. </span></span></p><p><span style="font-size: medium;"><span style="font-family: Times New Roman;"><strong>Results: </strong>Participants were from three southern states and included 11 males and nine females with 18 Caucasian and two African American. The average age of participants at the time of the interview was 71.5 years, and the average quitting age was 60.5 years. Four global themes related to tobacco cessation in older adults emerged from the analysis: (a) motivators, (b) facilitators, (c) barriers, and (d) life after tobacco. These older adults attribute their successful tobacco cessation to self-motivation, accountability to self and others, and finding replacements for tobacco. Barriers to tobacco cessation included tobacco triggers/temptations and addiction/withdrawal symptoms. Participants described themselves as proud, strong, and independent after quitting.</span></span></p><p><span style="font-size: medium;"><span style="font-family: Times New Roman;"><strong>Conclusion: </strong><a href="http://www.buletinlokal.com">Information</a> gained from older adults who have ceased using tobacco products can be used to develop tobacco cessation interventions that health care providers can use to assist older patients who desire to quit.</span></span></p> Lana M. Brown ##submission.copyrightStatement## 2015-06-23 2015-06-23 4 1 22 33 A Baseline Assessment Survey on Cultural Competency among Expatriate Nurses in Saudi Arabia http://ijn.in/index.php/ijn/article/view/180 <p align="center"><strong>Abstract</strong></p><p><em>The culture of Saudi Arabia is dominated by the values and virtues of Islam. </em><em>Its increasing multicultural population of health care workers poses a significant challenge in providing individualized and holistic care to their patients.</em><em> </em><em>This descriptive study served as a baseline assessment survey to determine the level of competence among expatriate nurses in providing culturally competent nursing care. The Individual Assessment of Cultural Competence, with approval from the Institution Review Board (IRB), was administered to 584 expatriate nurses of a University Hospital in Kingdom of Saudi Arabia. The findings of the study showed that majority of the respondents were Indians and Filipinos, with a frequency percentage of 53% and 39%, respectively. They were culturally competent in providing nursing care and there was significant difference in their cultural competency when grouped according to their age, gender, educational status, nationality and length of service. The university hospital, recognizes the importance of cultural competence in the caring professions with the presence of diverse workforce. Hence, professional development programs are continually conducted to provide the nursing staff with the needed information primarily about Saudi culture. </em></p> ERGIE PEPITO INOCIAN ##submission.copyrightStatement## 2015-06-23 2015-06-23 4 1 58 66 Evidence-based practice project to increase hospital-based cervical cancer screening compliance among registration staff http://ijn.in/index.php/ijn/article/view/193 <strong>Background:</strong> High-quality Papanicolaou testing was developed in the 1940s, and when used for early detection of cervical cancer, has been shown to significantly reduce cervical cancer related deaths world-wide. Legislation, passed by many states in the United States, aims to maximize cervical cancer screening. One academic medical center (AMC) in Maryland initiated a cervical cancer screening program in 1977. A pilot, developed to assess cervical cancer screening compliance, found the screening rate at this AMC to be 51%. <strong></strong><p><strong>Objective:</strong> This project aimed to improve the knowledge of the patient service coordinators in order to increase cervical cancer screening compliance.</p><p><strong>Population:</strong> Patient service coordinator conducts registration and screening when a patient is admitted to the AMC<strong></strong></p><p><strong>Methods</strong>: Effectiveness of the education was measured by three assessments: 1) A pre and post knowledge survey of the patient service coordinator measuring facts about cervical cancer, the screening process, and the State of Maryland cervical cancer screening mandate; 2) a calculation of screening rates comparing the number of women screened to the number of women admitted; and 3) an assessment of the completeness of each screening form.<strong></strong></p><p><strong>Results</strong>:<strong> </strong>A two-tailed paired samples <em>t</em>-test revealed that the PSCs scored higher on the post-survey (<em>m</em>-7.68, <em>s</em>- 2.52) compared to the pre-survey (<em>m</em>-3.68, <em>s</em>-1.77), <em>t </em>(32) = 8.949, p ≤ .0.5. A chi- square test was used to compare categorical variables. During the four weeks before the educational intervention, 34% (543 of 1602) of women were screened; 51% (279/543) screening forms were completed. For the four weeks after the educational intervention, 54% (N=735 of 1,373) of eligible women were screened; 89% (656/735) forms were completed. Both tests were found to be significant p &lt;0.000.</p><p><strong>Interpretation:</strong> There was a significant improvement of the PSC’s knowledge, 20% increase in the number of women screened, and completeness of the form increased by 38%.<strong></strong></p><p><strong>Conclusion:</strong> These findings suggest that an educational intervention for registration staff can increase cervical cancer screening compliance, and positively impact staff ability to screen inpatient women.</p> Lynn Richards-McDonald ##submission.copyrightStatement## 2015-06-17 2015-06-17 4 1 75 87 Nursing Student Engagement: Student, Classroom, and Clinical Engagement http://ijn.in/index.php/ijn/article/view/195 <p>A nursing student’s level of engagement is extremely important. Their engagement efforts impact their current and future learning, their clinical care interactions, and ultimately, ongoing retention within the nursing profession. The <em>level</em> of engagement with the nursing role and responsibilities will contribute toward the patients’ quality of healing. Interventions toward wellness, provided with engagement, create nurturing and supportive caring. Student education must facilitate engagement by being relevant and evidence-based. The current concept of student engagement is outlined in the following sections: engagement definitions, nursing student engagement, classroom engagement, and clinical engagement.</p><p>An up-to-date literature review of student nurses’ engagement in learning is presented; gaps in the literature are identified. Engagement is not a new teaching strategy, however, it has recently become extremely popular and effective as traditional lectured education is becoming replaced by this more active and participatory teaching and learning methods.</p> Kathleen F. Hudson ##submission.copyrightStatement## 2015-06-17 2015-06-17 4 1 44 52 Synthesizing Preliminary Normative Values for the Hong Kong Brief Version of World Health Organization Quality of Life Scale: A Review of Published Studies 1997 - 2014 http://ijn.in/index.php/ijn/article/view/231 <p><span style="font-family: 新細明體;"><em><strong><span style="font-size: medium;">Objective</span></strong></em><em><strong><span style="font-size: medium;">.</span></strong></em><em></em></span><span style="font-size: medium;">To </span><span style="font-size: medium;">synthesize</span><span style="font-size: medium;">preliminary </span><span style="font-size: medium;">normative values from published data of the Hong Kong version of World Health Organization</span><span style="font-size: medium;">Quality of life scale–brief version (WHOQOL-BREF-HK)</span><span style="font-size: medium;"> and to identify areas for nursing attention and further research.</span></p><p><span style="font-family: Calibri;"><em><strong><span style="font-size: medium;">Design</span></strong></em><em><strong><span style="font-size: medium;">.</span></strong></em><em><span style="font-size: medium;"> A </span></em></span><span style="font-size: medium;">literature</span><span style="font-size: medium;"> review. </span></p><p><span style="font-family: Calibri;"><em><strong><span style="font-size: medium;">Data sources</span></strong></em><em><strong><span style="font-size: medium;">.</span></strong></em><em></em></span><span style="font-size: medium;">The literature </span><span style="font-size: medium;">search was perfo</span><span style="font-size: medium;">r</span><span style="font-size: medium;">med from January 1997 to </span><span style="font-size: medium;">December</span><span style="font-size: medium;"> 2014. </span><span style="font-size: medium;">Keywords including WHOQOL-BREF-HK, Quality of life, Brief, Scale, and Hong Kong Chinese were used to search the following electronic data bases: Journals @ Ovid Full Text, EBM Reviews, EMBase, PsycInfo, DARE and Ovid Medline. In addition, hand searching of the reference lists of retrieved articles was performed.</span><span style="font-size: medium;">  </span></p><p><span style="font-family: Calibri;"><em><strong><span style="font-size: medium;">Review methods</span></strong></em><em><strong><span style="font-size: medium;">.</span></strong></em><em><strong></strong></em></span><span style="font-size: medium;">Studies were selected when they adopted the WHOQOL-BREF-HK as a measurement. The scale has four domains. Studies with incomplete domain data were excluded. The </span><span style="font-size: medium;">WHOQOL-BREF-HK</span><span style="font-size: medium;"> data were extracted from the selected studies by one of the authors independently and checked by the other author to ensure accuracy. The extracted data, presented in raw score, are considered as the preliminary normative values.</span></p><p><span style="font-family: Calibri;"><em><strong><span style="font-size: medium;">Results</span></strong></em><em><strong><span style="font-size: medium;">.</span></strong></em><em></em></span><span style="font-size: medium;">The </span><span style="font-size: medium;">twenty-three</span><span style="font-size: medium;"> studies selected </span><span style="font-size: medium;">for the review </span><span style="font-size: medium;">included </span><span style="font-size: medium;">3,480</span><span style="font-size: medium;"> subjects</span><span style="font-size: medium;">(mean age </span><span style="font-size: medium;">ranged from </span><span style="font-size: medium;">31</span><span style="font-size: medium;"> to </span><span style="font-size: medium;">76 years). </span><span style="font-size: medium;">The preliminary n</span><span style="font-size: medium;">ormative values</span><span style="font-size: medium;"> were </span><span style="font-size: medium;">displayed in a</span><span style="font-size: medium;">table to show the mean score of the four domains of the WHOQOL-BREF-HK of each study by subject classifications</span><span style="font-size: medium;">(subject characteristics, sample size, mean age, </span><span style="font-size: medium;">percentage of </span><span style="font-size: medium;">female</span><span style="font-size: medium;"> subjects</span><span style="font-size: medium;">), and by three </span><span style="font-size: medium;">categories</span><span style="font-size: medium;"> of people (well, sick and</span><span style="font-size: medium;">those with specific life events). </span><span style="font-size: medium;">Our synthesis shows some interesting trends, including </span><span style="font-size: medium;">people with schizophrenia tend to have the poorest </span><span style="font-size: medium;">quality of life</span><span style="font-size: medium;">, </span><span style="font-size: medium;">and </span><span style="font-size: medium;">sick people after</span><span style="font-size: medium;"> completing</span><span style="font-size: medium;">a course of </span><span style="font-size: medium;">treatment with a possible remission tend to achieve </span><span style="font-size: medium;">quality of life</span><span style="font-size: medium;"> similar to well people. </span><span style="font-size: medium;">These trends deserve nursing attention and further research with a population-based sample.</span><em><span style="font-size: medium;">  </span></em></p><p><em><strong><span style="font-family: Calibri; font-size: medium;">Conclusions</span></strong></em><strong><em><span style="font-size: medium;">.</span></em></strong><strong><em></em></strong><span style="font-size: medium;">Given that population-based normative data for WHOQOL-BREF-HK are unavailable, </span><span style="font-size: medium;">the</span><span style="font-size: medium;"> values </span><span style="font-size: medium;">presented in this study, although limited by not using methodological recommendations for normatization of quality of life instruments, </span><span style="font-size: medium;">offer a </span><span style="font-size: medium;">preliminary and helpful source</span><span style="font-size: medium;"> for cross references for Chinese people living in Hong Kong. Our</span><span style="font-size: medium;">findings</span><span style="font-size: medium;"> also</span><span style="font-size: medium;"> provide pointers for further research</span><span style="font-size: medium;">, and </span><span style="font-size: medium;">help nurses to make better decisions in </span><span style="font-size: medium;">clinical </span><span style="font-size: medium;">practic</span><span style="font-size: medium;">e.</span></p> Suk-ming Yeung Ann TY Shiu ##submission.copyrightStatement## 2015-06-17 2015-06-17 4 1 1 10 Multifactor examination of nursing job satisfaction: a cross sectional survey in a tertiary hospital, Qatar http://ijn.in/index.php/ijn/article/view/247 <p><strong>Objectives</strong>: This study examined overall job satisfaction among nurses in a tertiary hospital setting in order to understand the relationship between job satisfaction in terms of four dimensions: autonomy, work environment, incentives, and perception of quality of patient care.</p><p><strong>Methods</strong>: A cross sectional study of 435 nurses at Rumailah Hospital, Doha, Qatar was conducted using a validated Nursing Work Index-Revised questionnaire. Stepwise multiple linear regression was conducted to examine predictors of nursing job satisfaction.</p><p><strong>Results</strong>: The study included 435 respondents, 68.2% of whom were hired from abroad. Mean age of respondents was 38.42±8.96. Most were female (87.1%), educated to degree level (50.6%), were married (84.5%), and work at the staff nurse level (84.1%). A majority (65.8%) of respondents had over five years of experience at current job. Overall, a greater proportion of respondents (53.3%) rated satisfaction with current job above 5, on a 10 point scale. Nurses from abroad tended to have higher ratings of job satisfaction compared to locals.  There was no statistically significant difference in mean job satisfaction score by practice area (t=4.467, p =.0.139).</p><p><strong>Conclusion</strong>: Expat Nurses tended to rate job satisfaction higher than those hired locally.  Incentives (including financial and non-financial benefits) was a significant predictor of nursing job satisfaction. Autonomy and contract type were additional statistically significant predictors of job satisfaction, after adjusting for confounders.  </p> Badriya Khalifa Al Shamari Johncy Paulose Christine Ou Emmanuel Ngwakongnwi ##submission.copyrightStatement## 2015-06-17 2015-06-17 4 1 11 21 Caring for the chronically ill patient: understanding how fear leads to activity avoidance in individuals with chronic respiratory disease. http://ijn.in/index.php/ijn/article/view/93 The likelihood of taking preventative health actions, such as engagement in physical activity, is affected by individual motivation along with the perceived threat of existing disease. Chronic respiratory disease enhances perceived threat of activity-induced dyspnea and alters the perception of barriers to preventative action. This leads to decreased likelihood of taking the recommended positive health action and engaging in physical activity. Resulting behavior instead is focused on avoidance of disease exacerbation in the form of activity avoidance. Sarah Miller ##submission.copyrightStatement## 2015-02-02 2015-02-02 4 1 11 16 FAMILY SUPPORT NEEDED FOR ADOLESCENT WHEN PUBERTY PERIOD http://ijn.in/index.php/ijn/article/view/74 <span class="hps"><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-fareast-font-family: Cambria; mso-fareast-language: EN-US; mso-ansi-language: EN-US; mso-bidi-language: AR-SA;">Adolescents</span></span><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-fareast-font-family: Cambria; mso-fareast-language: EN-US; mso-ansi-language: EN-US; mso-bidi-language: AR-SA;"> <span class="hps">during their</span> <span class="hps">puberty</span> <span class="hps">will</span> <span class="hps">experience many</span> <span class="hps">physical and psychological changes</span> <span class="hps">that are</span> <span class="hps">very</span> <span class="hps">fast</span>. <span class="hps">Physical changes</span> <span class="hps">of puberty</span> <span class="hps">teens</span> <span class="hps">give effect to</span> <span class="hps">changes in</span> <span class="hps">psychological</span> <span class="hps">and social</span>. <span class="hps">Shape</span> <span class="hps">changes that</span> <span class="hps">accompany</span> <span class="hps">puberty</span> <span class="hps">include</span> <span class="hps">changes in</span> <span class="hps">cognitive</span>, <span class="hps">moral</span>, emotional, social <span class="hps">as a</span> <span class="hps">form of</span> <span class="hps">self-</span>development of <span class="hps">adolescents</span>. <span class="hps">Families</span> <span class="hps">have</span> <span class="hps">an important role</span> <span class="hps">to</span> <span class="hps">help</span> <span class="hps">youth</span> <span class="hps">grow</span> <span class="hps">and</span> <span class="hps">develop normally</span> <span class="hps">during puberty</span>. <span class="hps">Reality on the ground</span> <span class="hps">are still</span> <span class="hps">many families</span> <span class="hps">that have not been</span> <span class="hps">able</span> <span class="hps">fully</span> <span class="hps">to</span> <span class="hps">implement the</span> <span class="hps">family support</span> <span class="hps">to</span> <span class="hps">adolescents</span> <span class="hps">undergoing</span> <span class="hps">puberty</span>. <span class="hps">The purpose</span> <span class="hps">of this study</span> <span class="hps">to</span> <span class="hps">obtain</span> <span class="hps">the necessary</span> <span class="hps">family</span> <span class="hps">support</span> <span class="hps">during their</span> <span class="hps">teenage</span> <span class="hps">puberty</span>. <span class="hps">The design</span> <span class="hps">study is a</span> <span class="hps">qualitative</span> <span class="hps">phenomenology</span>. <span class="hps">Researchers conducted</span> <span class="hps">in-depth</span> <span class="hps">interviews</span> <span class="hps">of</span> <span class="hps">adolescent</span> <span class="hps">puberty</span>. <span class="hps">Data analysis</span> <span class="hps">using</span> <span class="hps">Colaizzi</span> <span class="hps">method</span>. <span class="hps">The first theme</span> <span class="hps">is the role</span> <span class="hps">of</span> <span class="hps">perceived</span> <span class="hps">family (support,</span> <span class="hps">negative</span> <span class="hps">attitudes</span> <span class="hps">and rules)</span>. <span class="hps">The second theme</span> is <span class="hps">the expected</span> <span class="hps">behavior of</span> <span class="hps">adolescent</span> <span class="hps">family</span> <span class="hps">(needed</span>, <span class="hps">considered,</span> <span class="hps">understood</span>, <span class="hps">satisfied,</span> <span class="hps">given</span> <span class="hps">the right to</span> <span class="hps">argue</span>, <span class="hps">improved</span> <span class="hps">communication</span>, <span class="hps">allowed to play</span>, <span class="hps">directed</span> <span class="hps">and</span> <span class="hps">controlled)</span>. <span class="hps">Researchers</span> <span class="hps">suggest</span> <span class="hps">the formation of</span> <span class="hps">adolescent</span> <span class="hps">peer</span> <span class="hps">counselor</span>, <span class="hps">clinical</span> <span class="hps">consultation</span> <span class="hps">and</span> <span class="hps">promotion family support for adolescent</span></span> Endang Triyanto ##submission.copyrightStatement## 2015-02-02 2015-02-02 4 1 51 57 Understanding the Experience of stress on initiation of Haemodialysis: A Phenomenological Study http://ijn.in/index.php/ijn/article/view/230 <p><strong>Background:</strong> Research evidence on stress among chronic kidney disease/end stage renal disease patients in India is sparse. Experience of stress is a subjective phenomenon. Hence qualitative research methodology helps to gain real insight about factors that cause stress among haemodialysis patients. The objective of this study was to understand the stressors experienced by patients on initiation of haemodialysis treatment.</p><p><strong>Methods:</strong> A phenomenological approach was used to gain insight into the lived experience of stressors experienced by patients’ on haemodialysis treatment. The study was conducted in outpatient haemodialysis units of two private hospitals in Bangalore, India. Participants of the study consisted of six males and four females who were on haemodialysis for between 2 months to 36 months. Individual semi-structured interviews were conducted with all participants. All interviews were audio-taped and transcribed verbatim .</p><p><strong>Results:</strong> Content analysis was used to analyze the data. Three main themes emerged namely ‘Physical stress- ors’, ‘psychological stressors’ and ‘Socioeconomic stressors’. Pain, tiredness and loss of appetite were the predominant physical stressors reported by participants. Shock and depression on diagnosis and initiation of dialysis, difficulty adhering to prescribed therapeutic regimen, feeling of being burden on family, fear of complications and uncertainty about life were the psychological stressors reported by participants. A range of socioeconomic stressors were reported by the participants which included; Loss of employment, financial problems, loss of ability to perform activities of daily living and limited social life.</p><p><strong>Conclusion:</strong> Findings of this study can be utilized to design a pre-haemodialysis preparatory program which can be implemented for stage-4 chronic kidney disease patients to prepare them for haemodialysis.</p><p> </p> Jadhav Sonali Tarachand Premila Lee ##submission.copyrightStatement## 2015-01-29 2015-01-29 4 1 11 19 Letter to Editor: Response to the topic “Nursing Shortage: A Comparative Analysis” http://ijn.in/index.php/ijn/article/view/229 <p>Dear editor:</p><p>I am writing this letter in response to article “Nursing Shortage: A Comparative Analysis” which made me think about the similar situation of my country. I am from Nepal, a developing country which is facing the nursing shortage as you have mentioned in the article. If you ask a nursing student in my country, what are you going to do after graduating? Most of those answers would be going abroad for bachelor or masters. Here, doing bachelor or masters means they want to get blended with the students of the respective country for licensure and degree equivalence so that they could easily get a permanent visa of that country. As you have mentioned in your article about Philippines that they are educating more nurses than they need, we have a same situation in my country too.</p><p>The number of nursing college is increasing so is the number of nurses. There is less demand and more supply of nurses to the health care system. Another major problem we are facing is due to political instability, the governing bodies are malfunctioning which affects the quality of education provided to our nurses, resulting in quality of care they provide to their patients.</p><p>The real problem actually starts after graduation. Nurses are not able to find jobs. They are asked about their experience, which new nurses would not have. Nowadays there is a trend of volunteering by nurses, which are forced by hospital administrations so that the nurses could get a job in that hospital. Poor Nurses could only see their option of moving abroad and have a better life.</p><p>The most important reason of moving to develop countries is the money. Nepalese nurses hardly make</p><p>$250 a month, which makes you difficult to survive in the country. Even if you have a bachelor or masters de-</p><p>gree you would be making about $300 comparing the USA nurse making $60, 000 a year. This situation makes the nurses in my country very motivated and they want to try everything possible to go to developed countries and have a fascinated lifestyle.</p> Sharma DW ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 1 1 Being engaged: The multiple interactions between job demands and job resources and its impact on nurses engagement http://ijn.in/index.php/ijn/article/view/155 <p>This study has been inspired by  the job-demands resource model. It evaluates the role that job resources play in moderating the impact that job demands have on work engagement in a community of nurses. A total of 481 nurses in 109 health care centers participated in this study. Three job demands: work overload, emotional demands, and home-work imbalance; and three specific job resources: social support, autonomy, and self-development opportunities were used to test the interaction hypotheses of this research. Results show that 33 out of 36 of the possible interaction effects were significant, thus showing that job resources create a buffer between job demands and work engagement and its three dimensions in nurses. By and large,   hypotheses were confirmed. Research and practical implications are discussed. </p> Rachel Gabel-Shemueli Simon Landau Dolan Adriana Suárez Ceretti ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 17 32 Gender differences in population-based prevalences of cardiovascular and cerebrovascular diseases in Chile: are men being under-diagnosed? http://ijn.in/index.php/ijn/article/view/141 <p><strong>Background:</strong> Cardiovascular diseases (CVD) are the biggest killer worldwide. Chile has a long standing CVD preventive system, but no gender-focused study has been conducted so far. The purpose of this study was to analyse the existence of gender differences in the prevalence of CVD in Chile. This was a secondary analysis of the cross-sectional Chilean Health Survey 2009- 2010, including 5277 adult participants. </p><p><strong>Method:</strong> The relationship between CVDs and gender, crude and adjusted by potential confounders, were estimated by weighted Poisson regressions.</p><p><strong>Results and discussion:</strong> Crude overall prevalence of self-reported hypertension was 28.13% and it was significantly lower in men (10.92%) than women (17.20%). Half of the population were overweight/obese (39.20%/22.92%) and alcohol consumption in the past month was high (58.42%). Around 40.19% currently smoke. Gender was significantly associated with hypertensions (PR 1.58, 95% CI [1.23-2.03]) as well as having public healthcare insurance (PR1.45, 95% CI [1.01-2.10]).</p><p><strong>Conclusion</strong>: The results suggest that men reported hypertension less often than women, but comparisons with objective measures suggested they were under-diagnosed. These discrepancies need further consideration in preventive programmes and gender-focused policies in Chile. Nurses and other health professionals are key in creating, implementing and evaluating novel recruitment strategies for men.</p> Corinna Dressler Báltica Cabieses ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 39 50 How Healthcare Providers Manage Intensive Care Patients’ Stressors? http://ijn.in/index.php/ijn/article/view/130 <p><strong>Purpose:</strong> This manuscript reports the qualitative findings of a mixed methods research study conducted in December.2012. This manuscript focus on describing how health care providers managed their patient’s stressors in the intensive care units (ICU).</p><p><strong>Background:</strong> Approximately 4.4 million patients require intensive care unit (ICU) treatment annually in the United States (National Quality Measures Clearing House, 2012).No specific protocol is present to guide the health care providers in managing their ICU patients' stressors. There is a need to investigate how health care providers manage their patients stress.</p><p><strong>Methodology: </strong> Mixed methods research design was used. Phenomenological approach was used for the qualitative section. The sample included 70 ICU health care providers. The researcher developed a paper based tool that asked participants about their demographic data, and asked open ended questions investigated how health care providers managed their patient's stressors. Consent forms were signed voluntarily by all participants; all ethical considerations were guaranteed in this study. This study was conducted in one of the large hospitals in southern California that have 46 ICU beds.</p><p><strong>Findings:</strong> Health care providers reported that they manage their ICU patient's stressors by implementing four themes of practice: Communication, pain management, encouraging the presence of family, and environmental control. Those were the major strategies in health care providers' management of patients' stressors. Study implications: ICU staff can manipulate the ICU environment to be less stressful; the findings of this study could guide the development of ICU patients stress management protocol.</p> Alham Abuatiq ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 3 10 Examining demographic and psychosocial predictors of well-being in older pet owners http://ijn.in/index.php/ijn/article/view/108 <p>Background: Worldwide, older adults represent a significant proportion of the total population. Due to the international increase in the numbers of aging adults over the next several decades, it is important for nurses to assist this populace in aspects of healthy aging. There are known indicators of well-being both positive and negative that influence aging.</p><p>Objective: The objective of this study was to examine seven models consisting of demographic and psychosocial predictors of well-being among older adults.</p><p>Population: This quantitative descriptive design included 209 older pet-owning adults whose age ranged from 48 to 93 (<em>M </em>= 71.66; <em>SD</em> 9.14). The participants were recruited from senior housing facilities designed for older adults or attended a senior citizen community center.</p><p>Methods: Participants completed a demographics form and a loneliness, pet attachment, social support, and well-being scale. Demographic and psychosocial predictors of well-being were examined using hierarchical regression analysis (<em>p</em> <span style="text-decoration: underline;">&lt;</span> .05).</p><p>Results: The results revealed that age, gender, education, health, loneliness due to the loss, pet type, loneliness, social support, and pet attachment were significant predictors.</p><p>Interpretation: Older adults are at risk for less than optimal well-being due to situational factors such as loneliness and alternations in social support due to natural life transitions. Since well-being is a multidimensional construct that affects the world’s people it is important for nurses to investigate its components.</p><p>Conclusion: Internationally, nursing is focused on maintaining positive health and well-being throughout the lifespan. The findings supported both positive and negative components influence well-being. Appropriate interventions should be selected based on positive or negative predictors. Implications for clinical application are discussed.</p> Cheryl A. Krause-Parello Elsie Gulick ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 29 42 The Evolution of Nursing http://ijn.in/index.php/ijn/article/view/104 <p>Everything in this universe is subject to countless refurbishes. The modifications are invariably met for the development of a certain ideology or substance. This is just one of the many explanations why “there is nothing constant in this world, but change.”</p><p>            In the field of nursing, various principles are being undertaken, and it is but right for us, nurses to develop innumerable revisions to attain precision, thereby improving our Health Care Delivery System to our clients seeking for medical and nursing care.</p><p>            Nursing is not a static, unchanging profession but it is continuously growing and evolving as society changes, as health care emphases and methods change, as lifestyle change – and as nurses, themselves change (Potter &amp; Perry, 2005). In this article, one will be able to apprise himself/herself with the up-to-date trends in the field of nursing specifically on Cardiopulmonary Resuscitation.</p> Carlo Paul Sana ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 1 2 A Descriptive Study to Assess Barriers to Screening for Domestic Violence Among Public Health Nurses http://ijn.in/index.php/ijn/article/view/89 <!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:RelyOnVML/> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><p class="MsoNormal" style="line-height: normal;"><span style="mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Domestic violence is a public health issue and public health nurses are in the best position to track it, provided they can overcome certain screening barriers. This study aimed to identify the main barriers public health nurses face while screening patients for domestic abuse. A quantitative, descriptive survey was distributed to public health nurses stationed </span>in three regional public health offices in a large, urban county in Northern California. Thirty-two nurses responded to the survey. Pender’s Health Promotion Model was utilized as a theoretical framework <span style="mso-bidi-font-size: 12.0pt;">to test and improve nurses’ screening skills by identifying perceived barriers to action and by assessing situational influences. The study results showed three main identified barriers among public health nurses to be a lack of privacy, negative feelings and attitudes regarding screening, and a lack of time. By providing in-service training, educational materials, and accessible computer applications, public health departments can help nurses overcome these barriers. 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UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:PMingLiU; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--> Fataneh Farbood ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 42 50 Relationship between sub-health and occupational stress among operating theater nurses in China: A questionnaire survey http://ijn.in/index.php/ijn/article/view/81 <p>Objectives: Studies on sub-health status in general community populations are common, but there is a dearth of research on sub-health of operating theater nurses in China. This study is to explore the relationship between sub-health and occupational stress among operating theater nurses.</p><p>Design and Sample:<strong> </strong>A cross-sectional questionnaire study was conducted in an operating center in China in December 2007 among 70 operating theater nurses.</p><p>Measures: Nurse occupational stressor scale and the diagnostic criterion of sub-health were used. Percentile, <em>t</em>-test and regression were employed for statistical analysis.</p><p>Results:<strong> </strong>Nurses reported high stress levels in workload and time pressure subscale, followed by professional and career issues, patient care and interaction, interpersonal relationships and management issues, resource and environmental problems. Fifty subjects (76.9%) suffered from one or more sub-health symptoms. Fatigue was the most common symptom. Occupational stress was positively correlated with age, duration of work in OT, designation, and attending continuing education. Female nurses experienced more stress in workload and time pressure. The occupational stress experienced by sub-health nurses was higher than <a href="http://tipsdankiathidupsehat.blogspot.com" STYLE="text-decoration: none">healthy life</a>.</p><p>Conclusion: The operating theater nurses in our study experienced higher occupational stress and most of them were suffering from sub-health. Occupational stress was related to sub-health status.</p> Yuhua Gong Hui Zhou ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 2 10 Comprehensive Review of the Papers Presented at the 7th International Nurse Practitioner/Advanced Practice Nursing Network Conference http://ijn.in/index.php/ijn/article/view/73 <p><strong>Objectives:</strong>  Advance practice nurses are not currently prepared to understand the differences and similarities in educational preparation, scope of practice, and governing regulations from a global perspective.  The purpose of this review was to develop themes and identify differences in practice from an international advance practice perspective.</p><p><strong>Design:</strong> A comprehensive review was done of the abstracts submitted to the 7th International Nurse Practitioner/Advanced Practice Conference.</p><p><strong>Data Sources:</strong> Abstracts presented at the 7th International Nurse Practitioner/Advanced Practice Nursing Network Conference.</p><p><strong>Review Methods:</strong>  In order to conduct a comprehensive review of the abstracts, the 238 abstracts  were organized and placed in a table by type of research, clinical scope of practice, country of origin, and type of institutions represented. A meta-analysis was done of the abstracts to summarize, evaluate, and analyze common themes.</p><p><strong>Results:</strong>  Common themes in the abstracts emerged as, the use applied research, advanced practice professional regulation, and the educational preparation of nurse practitioners.</p><p><strong>Conclusions:</strong>  In an effort to meet the demands of patients, nurse practitioners are the ideal providers to provide quality, cost-effective care. They are specifically educated to manage acute and chronic illnesses and they can meet the demands of primary health care needs.  This conference brought together leaders in nursing with a common goal of sharing research, experiences, and to help understand the complex healthcare interventions and polices that affect APN practice.</p> Kimberly Christine DeVine ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 33 38 A survey of Patients and staff satisfaction with a Rapid Response Psychiatric Liaison Service in an Acute Hospital: Are Elderly Patients Easier to please? http://ijn.in/index.php/ijn/article/view/48 <p>Background and Objectives:</p> <p>The provision and quality of mental health services in Acute General Hospitals is a growing concern. Developing research to elicit the views of patients and staff will offer insights into service improvements.  The Rapid Assessment, Interface and Discharge service (RAID) developed in an Acute General Hospital to deliver a rapid-response, 24-hour, 7-day- a- week, age-inclusive intervention was evaluated for its impact on staff satisfaction, with emphasis on staff training; and patient satisfaction, with emphasis on the differences in satisfaction between working age (under 65 years) and older adults (over 65 years).</p> <p>Population:</p> <p>Staff working in acute hospital for patients with mental health needs, and patients presenting to acute hospitals, requiring clinical input for their mental health.</p> <p>Method:</p> <p>Data on patient satisfaction was collected through a structured telephone questionnaire including fixed and open-ended questions.  Data related to staff satisfaction regarding the service provided was collected by a semi-structured interview administered face-to-face with staff from wards referring to the team.  Training was evaluated using open-ended, Likert-scale and open-ended questionnaires.</p> <p>Results:</p> <p>Results show that the majority of working age patients rated the service as ‘good’ (42.2%), felt that the team was helpful in their care (84.8%), met their mental health needs (69.7%), and treated them with respect (96.1%). Overall, older adults rated the service as ‘excellent’ (58.3%), felt that the team was helpful in their care (85.7%), met their mental health needs (85.7%), treated them with respect (92.9%) and stated that they were seen in good time (100%). The difference in satisfaction levels between patients of working age and older patients was statistically significant.</p> <p>Common aspects staff rated as most helpful were advice on managing patients (12.0%), support of staff (11.0%) and advice on medication (11.0%). The majority of staff surveyed felt that their practice would be improved following the training, and rated it as either excellent (61.6%) or good (36.3%).</p> <p>Interpretation and Conclusion:</p> <p>This study highlighted the benefits of providing support and training to staff working directly with patients with mental health needs.  It is more challenging to measure the satisfactory effect of older people who continue to give favourable answers on satisfaction questionnaires.</p> George Tadros Paul Kingston Nageen Mustafa Eliza Johnson Selina Balloo Juhi Sharma ##submission.copyrightStatement## 2015-01-28 2015-01-28 4 1 20 28 A Qualitative Study on Preparing Baccalaureate Nursing Students for Community/Public Health Nursing as Perceived by Nurse Educators and Administrators http://ijn.in/index.php/ijn/article/view/121 <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:DontVertAlignCellWithSp/> <w:DontBreakConstrainedForcedTables/> <w:DontVertAlignInTxbx/> <w:Word11KerningPairs/> <w:CachedColBalance/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="&#45;-"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument> </xml><![endif]--><p class="MsoNormal" style="text-align: center;" align="center">Abstract</p><p class="MsoNormal"> </p><p class="MsoNormal" style="margin-right: -.3in; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;">Background:</strong> Educational preparation of baccalaureate nurses remains entrenched in yesterday’s health care, hospital-centric environment. A culture change among nurse educators and in nursing education is needed to prepare competent practitioners capable of practicing from a health promotion/ disease prevention, community/population focused construct.</p><p class="MsoNormal" style="margin-right: -.3in; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;">Objective</strong>: This study utilized a qualitative phenomenological research design to determine the belief systems and values of baccalaureate nurse educators and administrators in preparing baccalaureate nursing students for community/public health nursing.</p><p class="MsoNormal" style="margin-right: -.3in; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;">Population</strong>: Thirteen nurse educators and six nurse administrators from two urban baccalaureate university schools of nursing participated in the study.</p><p class="MsoNormal" style="margin-right: -.3in; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;">Methods</strong>: An in-depth semi-structured interview based on Kotter’s 8-Step Change model was conducted.</p><p class="MsoNormal" style="line-height: 200%; mso-pagination: none; tab-stops: .5in; mso-layout-grid-align: none; text-autospace: none;"><strong style="mso-bidi-font-weight: normal;">Results</strong>: S<span style="mso-ansi-language: EN;" lang="EN">ix distinct belief systems and five personal and professional values emerged from analysis of the data. The six belief systems were: health care is really changing, nursing curriculum needs to change, nursing care begins in the community, nursing continues to be a growing and emerging profession, the baccalaureate nursing degree needs to be the entry level degree for nursing practice, and the motivation for being a nurse is to help others. The five values were: professionalism, compassionate care, collaborative practice, community service, and honesty, integrity, and credibility. Change, conflict, and challenge emerged as the major themes. </span></p><p class="MsoNormal" style="line-height: 200%; tab-stops: .5in;"><strong style="mso-bidi-font-weight: normal;">Interpretation:<span style="mso-spacerun: yes;">  </span></strong>A need for re-envisioning nursing education and practice to improve patient care and promote patient health and wellness from a community and population focused perspective is prompting the need for nurse educators and administrators to re-define and prepare a new nursing workforce for the 21<sup>st</sup> century. For a change in the educational approach to preparing baccalaureate nursing students to occur, it is critical that baccalaureate nurse educators and administrators acknowledge the role their belief systems and values play in preparing baccalaureate nursing students for practice in the changing national and global societal and health care environment.</p><p class="MsoNormal" style="line-height: 200%; tab-stops: .5in;"><strong style="mso-bidi-font-weight: normal;">Conclusion:</strong><span style="mso-spacerun: yes;">  </span>Further research is needed to determine the best curricular approach for preparing baccalaureate nursing students for community/public health nursing practice.</p><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true" DefSemiHidden="true" DefQFormat="false" DefPriority="99" LatentStyleCount="267"> <w:LsdException Locked="false" Priority="0" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Normal"/> <w:LsdException 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QFormat="true" Name="TOC Heading"/> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--> Mary Theresa Bouchaud JoAnn R Gurenlian ##submission.copyrightStatement## 2014-09-19 2014-09-19 4 1 43 55 Gastrointestinal bleed pathway documentation by nurses and physicians in Pakistan: a literature gap http://ijn.in/index.php/ijn/article/view/145 <p><strong>Background</strong></p><p>Upper gastrointestinal bleed is the serious medical condition which needs immediate interventions to prevent patients from serious complications. Nurses and physicians neglect gastrointestinal bleed pathway documentation which results in improper patient care management.</p><p><strong> </strong></p><p><strong>Aim of the study</strong></p><p>The aim of this paper is to overview the reviews on gastrointestinal bleed pathway documentation and also to identify the barriers of gastrointestinal bleed pathway documentation among physicians and nurses.</p><p><strong> </strong></p><p><strong>Methodology</strong></p><p>Literature search was undertaken in a systematic way to explore and review the existing literature related to documentation in GI bleed pathway and the barriers of documentation among nurses and physicians. For literature search, four major databases, CINHAL plus with full text, PUBMED, Cochrane library and JSTOR were used. Other search engine like Google scholar was also used to find the relevant literature. These databases were searched for the time period between 2000 and 2012.</p><p><strong> </strong></p><p><strong>Results</strong></p><p>The literature review reveals studies on effectiveness of gastrointestinal bleed pathway on patient’s outcome, effect of clinical pathway on documentation, and barriers of documentation in Clinical Pathway. However, none of the study focused specifically on gastrointestinal bleed pathway documentation among nurses and physicians in Pakistan.</p><p><strong> </strong></p><p><strong>Conclusion</strong></p><p>There is a gap in literature regarding physicians and nurses’ practice towards documentation of gastrointestinal bleed pathway in Pakistan. It is recommended that base line study is needed to overcome the issue of managing gastrointestinal bleed patients and to improve patients’ quality of care.</p><p><strong> </strong></p><p><strong> </strong></p><p><strong>Key Words</strong>: GI bleed, clinical pathway, documentation, Pakistan</p> Shahina Pirani ##submission.copyrightStatement## 2014-09-19 2014-09-19 4 1 22 26 Do family factors and gender influence violent behaviour in Thai adolescents?: A cross-sectional study http://ijn.in/index.php/ijn/article/view/112 <p><strong>Abstract</strong><strong></strong></p><p><strong>Background: </strong>Adolescent violence is one of the key social problems in Thailand. WHO (2002) has identified Thailand as 8<sup>th</sup> (out of 73 countries) in the number of murders committed by adolescents. A review of the literature found that one important factor may be the family environment (Laeheem et al, 2009; Ruangkanchanasetr et al, 2005; Isaranurug et al., 2001).  However, there is little evidence identifying relevant family characteristics in Thailand. Therefore, to prevent violent behaviour in Thai adolescents, relevant professionals need a better understanding of the family factors that promotes or inhibits violence.<strong></strong></p><p><strong>Objective:</strong> To identify risk and protective factors associated with the family that may influence violent behaviour in Thai adolescents and examine the role of gender.</p><p><strong>Methods</strong>: A cross-sectional survey was conducted among a representative sample of 400 adolescents aged 15-18 years in northern Thailand. Validated self-report questionnaires were used to collect data from adolescents in a public high school and a technical college. T-tests, correlation, and multiple regressions were used to examine the data.</p><p><strong>Results: </strong>Males reported having significantly more physical fights than females, whereas the females reported using significantly more verbal bullying than the male adolescents. The findings revealed that positive parenting practice, family relationship characteristics, and parent child attachment were negatively correlated (protective) and reduced the use of violent behaviour. Positive family relationship characteristics and high family income were identified as protective factors whereas father’s with a master degree<strong> </strong>was identified as a risk factor for violence in adolescents.</p><strong>Interpretation and Conclusions:</strong> Results suggest that males report more physical violence but females report more verbal bullying. Adolescents who receive practical support from their parents, and have a close relationship with their family were less likely to report violent behaviour. Therefore, positive parenting practice, family relationships and parent-child attachment could be strengthened and gender differences should be considered in the prevention of adolescent violence. Rungrudee Wongchum ##submission.copyrightStatement## 2014-03-08 2014-03-08 4 1 56 63 Effectiveness of the information booklet on the level of knowledge of the caregivers towards care of children with autism in the outpatient and inpatient of the child psychiatric centre at NIMHANS http://ijn.in/index.php/ijn/article/view/152 <p><em>Despite the growing incidence of autism, there is very little awareness on this developmental disability affecting 3-4 children in every 1,000 born in India today.</em><em> <strong>Aim: </strong>1. To prepare the information booklet on care of children with autism for the caregivers.2.To evaluate the effectiveness of the information booklet on the level of knowledge of the caregivers in the care of child with autism. <strong>Methodology:</strong> study was carried out by among 30 caregivers who were attending the inpatient and outpatient of child psychiatric centre, NIMHANS. A quasi experimental design with single group pretest - post test was used. A purposive sampling was used to select the caregivers. <strong>Instruments</strong> such as Socio demographic schedule, Knowledge questionnaire on care of children with autism which was prepared by the investigator was used to assess the changes in the level of knowledge among the caregivers before and after the administration of the information booklet. Knowledge questionnaire consisted of five dimensions: concept of autism, signs and symptoms, causes and common problems, assessment, diagnosis and intervention and handling common behaviour problems at home. After the pre-test the caregivers were given the information booklet. The post-test was conducted on the seventh day of administration of the information booklet. <strong>Analysis: </strong>Paired‘t’ test was used to find out the effectiveness of the information booklet on the level of knowledge and opinion. Chi-square test was used to find out the association of knowledge with selected socio demographic characteristics. Pearson correlation was used to find out the correlation between the knowledge of the caregivers of children with autism.</em></p><p><strong><em>Results: </em></strong><em>Findings revealed that, there was significant difference in the pre and post test scores on various dimension of knowledge questionnaire demonstrated the effectiveness of the information booklet. It was found that the post-test knowledge score was having statistically significant association with three socio demographic variables. <strong></strong></em></p> M Vijayarani ##submission.copyrightStatement## 2014-03-08 2014-03-08 4 1 27 35 Nursing students’ satisfaction http://ijn.in/index.php/ijn/article/view/77 <p><strong>Background:</strong> Survey of satisfaction from education line at the school is considered one of the fundamental issuesand essential component activities in the area of behavior and organizational performance. The aim of this study was to measure nursing students' satisfaction in School of nursing and midwifery.</p><p><strong> Method:</strong> This cross sectional study was analyzed nursing students’ satisfaction in six key areas. The data collection instrument was a questionnaire. The results showed that nursing students had little satisfaction with three key areas (school educational environment, clinical education environment, education review by school teachers, clinical education by clinical instructors, Communication with colleagues and social prestige).</p><p><strong>Results:</strong> The findings indicate that students had very little satisfaction with three key areas (evaluation by school teachers, evaluation of clinical instructors and quality of nursing management).</p><p><strong>Conclusion:</strong> According to thisstudy the majorityof students were little satisfied. Therefore, the satisfaction of all activities performed at the university is effective in motivating and finally education quality Promotion.</p> Ashrafalsadat Hakim ##submission.copyrightStatement## 2014-03-08 2014-03-08 4 1 36 42 Metaphor, Nurse’s Vehicle to Carry Caring Mind, An Analysis from Nursing Records http://ijn.in/index.php/ijn/article/view/72 <p align="left">Nursing textbooks advice students to use literal expression expressions, which are considered to be objective.  However, we recognize many metaphorical expressions are used by Japanese nurses.  We surveyed database of Japanese Nursing Practice Example Accumulation Center (Kawashima, Retrieved 2012/4/14).  The database included a large number of texts to explain nurses’ activities. </p><p align="left">Concepts developed in cognitive linguistics were used to excavate metaphors, then text mining was applied to sample metaphors systematically.  The sampled metaphors were classified by types of source domain.  Although it is needless to say that statements about emotions include metaphors, it was found that nurses use many metaphors in statements about facts.  Nurses expressions, which include metaphors, are often understated, but the survey of the metaphors revealed that inclusion of the metaphor is expression of caring mind by nurses.</p> Kanetoshi Hattori ##submission.copyrightStatement## 2014-03-08 2014-03-08 4 1 1 21 Editorial note http://ijn.in/index.php/ijn/article/view/149 Editor IJN Online ##submission.copyrightStatement## 2014-03-03 2014-03-03 4 1