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Journal of Nursing Science & Practice

Contents

1. An Indian Perspective of Needs and Problems Faced by the Family Caregivers of Mentally Challenged Children: A Review Article M. Vijayarani, G. Balamurgan

2. Mental Health Problems Related to Memory Loss among Senior Citizens Harpreet Kaur, Priyanka Dogra, Kanika

3. Treatment Approaches in Intracranial Hypertension: A Review Vijay V.R., Jaison Joseph

4. Factors Associated with Nursing Student's Intention to Leave Own Country Bharat Pareek, Jyoti Mahajan, Gurchetan Kaur

5. Nonrandomized Trial on Assertive Training Module among Nursing Students Poonam Devi, Bharat Pareek, N. Sujata

6. A Descriptive Study to Assess the Awareness Regarding Preconception Care among Married Women Planning for Pregnancy with a view to Conduct Health Teaching Programme in Selected Rural Areas of Ahmedabad District Vandana Chauhan

7. A Study to Assess the Knowledge and Practice of Married Women Regarding Prevention of Lower Reproductive Tract Infection at Bettahalsur, Bangalore Hetal Patel

8. A Descriptive Study on Prevalence of Health Problems, their Treatment-Seeking Behavior and Preventive Measures among Selected Class C Employees of PGIMER, Chandigarh, 2015â&#x20AC;&#x201C;2016 Sandhya Ghai, Mahesh Devnani, Neena Vir Singh, Suresh Kumar Bamania, Amardeep Kaur, Harpreet Kaur, Kirti Thakur, Navneet Kaur, Pushpreet Kaur, Shivani Thakur

9. A Study to Assess the Knowledge and Prevalence of Iron Deficiency Anemia among Adolescent Girls in a Selected College of New Delhi Sarita Ahwal

10.Nonpharmacological Methods Used in the Management of Pain Caused by Peripheral Intravenous Catheters Dilek YÄąlmaz, Yurdanur Dikmen

Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

An Indian Perspective of Needs and Problems Faced by the Family Caregivers of Mentally Challenged Children: A Review Article M. Vijayarani1,*, G. Balamurgan2 1

Department of Mental Health Nursing, ESIC College of Nursing, Indiranagar, Bangalore, Karnataka, India 2 Department of Mental Health Nursing, M.S. Ramaiah Institute of Nursing Education and Research, Bangalore, Karnataka, India

Abstract In India, the prevalence of mental retardation varies from 0.22 to 32.7 per thousand populations. The needs expressed by families of mentally challenged children are different from person to person and family to family. Basic needs are food, shelter and clothes. The most pertinent areas where parents need to have support and guidance are relieving them from a stressful situation, ensuring family stability, managing child’s maladaptive behaviour placement options and future planning for their mentally challenged child [1]. The present article throws light on the needs and problems faced by the family caregivers of mentally challenged children from the Indian perspective. Keywords: Mental retardation, child, challenges, parents, family, prevalence

INTRODUCTION In India, the prevalence of mental retardation varies from 0.22 to 32.7 per thousand populations. Becoming a parent of a mentally challenged child is not a choice of parents but it is forced upon them. Therefore, the birth of a mentally challenged child is a shock for them and they undergo hostile stage like shock, denial and anger before accepting the child. Therefore, they have special needs and extra requirement for child and family for the complete development of the child. Therefore, they require more support and help for various needs as per their requirement. Mentally challenged children are more and more dependent on their family caregivers and particularly on parents. Needs have been defined as the basic requirements expressed by an individual for survival [1]. Review on Needs and Problems Faced by Family Caregivers of Mentally Challenged Children The needs expressed by families of mentally challenged children are different from person to person and family to family. Basic needs are food, shelter and clothes [1]. The most pertinent areas where parents need to have

support and guidance are relieving them from a stressful situation, ensuring family stability, managing child’s maladaptive behaviour, placement options and future planning for their mentally challenged child [1, 2]. Individual or families of mentally challenged expressed their needs such as are social support, informative needs [1–3], financial needs, childcare needs, and professional support and community services. Informative needs are about mentally challenged children’s condition, about handling their behaviour, about how to teach such children, how to play or talk with them and their development [1, 2]. Mentally challenged children in families show negative and positive impact on family and family’s demand for some specific needs [1, 3]. Singh et al. found a negative impact (25.26%) which included difficulties in meeting extra demands for physical care of the child, experiencing health-related problems, making career adjustments, experiencing loss of support from the spouses, etc. [1, 3]. Also

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

Mental Health Problems Related to Memory Loss among Senior Citizens Harpreet Kaur1,*, Priyanka Dogra2, Kanika1 1

Department of Psychiatric Nursing, Gian Sagar College of Nursing, Punjab, India Department of Psychiatric Nursing, Netaji Subhash College of Nursing, Himachal Pradesh, India

Abstract Memory refers to a special ability of our mind to conserve or retain what has been previously experienced or acquired through hearing and then at some later stage enable us to make use of it by its reproduction or revival. Memory begins to deteriorate with ageing due to destruction of body tissues and degeneration of brain cells and is referred to as memory loss. Memory loss gives rise to many mental health problems which affects the day-to-day life activities of the senior citizens. The study aimed to explore the mental health problems related to memory loss among senior citizens. Ninety senior citizens were selected by purposive sampling technique. The data was collected from the selected senior citizens by using memory loss rating scale and questionnaire on mental health problems. The results of the study revealed that 25.6% of senior citizens had mild memory loss and 11.1% had moderate memory loss. 65.2% behaviour changes, 52.3% personality changes, 71.2% denial, 39.4% confusion, 61.4% anxiety, 18.2% suicidal tendencies, 12% problems with abstract thinking and 37.9% decreased judgement were found among 33 senior citizens with memory loss. It was concluded that majority of senior citizens who had memory loss had mental health problems also including behaviour changes, personality changes, denial, confusion, anxiety, suicidal tendencies, problem with abstract thinking and decreased judgment. Keywords: Mental health problems, memory loss, senior citizens

INTRODUCTION Memory is the process of maintaining information over time. It is a complex process, which involves learning, retention, recall and recognition. Memory plays a very important role in our learning and psychological growth. Through memory of our past experiences, we handle new situations; it helps us in our relearning, problem solving and thinking [1]. Aging is the accumulation of changes in a person over time. Aging in humans refers to a multidimensional process of physical, psychological and social change. Some dimensions of ageing grow and expand over time, while others decline. Life experiences increase while there is decline in the cognitive levels and functional ability. There is also decrease in the level of memory [2]. Memory loss is an unusual forgetfulness in which person may not be able to remember new events, recall one or more memories of the past, or both. Memory loss is a common complaint in

the primary care setting among the senior citizens. Memory loss is caused by progressive, irreversible degeneration and atrophy of the cerebral cortex and results in mental deterioration, usually over several years and there is a gradual impairment in memory [3]. Some things that can cause memory problems are bad reactions to certain medications, depression, dehydration (insufficient amount of fluids in the body), poor diet (insufficient vitamins and minerals), minor head injuries, and thyroid problems, Parkinson disease, multiple sclerosis, etc. [4]. In old age, the feeling like being neglected or disrespect may develop which may lead to emotional problems like sadness, loneliness, worrying, or boredom which can cause confusion and forgetfulness [5]. Normal aging is associated with a decline in various memory abilities in many cognitive tasks. As we age, our brain's memory retrieval system slows down, making it sometimes difficult to remember things as

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

Treatment Approaches in Intracranial Hypertension: A Review Vijay V.R.1, Jaison Joseph2,* 1

Department of Medical Surgical Nursing, College of Nursing, Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, India 2 Department of Psychiatric Nursing, College of Nursing, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

Abstract Intracranial hypertension is considered, when intracranial pressure (ICP) increases above 20 mmHg for a period of more than 5 min. A persistent rise in ICP produces compression effect over cerebral vasculature and reduces cerebral blood flow (CBF) and cerebral perfusion pressure (CPP). It results in brain stem compression and herniation, if left untreated. A systematic assessment of clinical status, serial and continuous monitoring of vital parameters and evidence based therapeutic regimen are required for the care of patient with intracranial hypertension. The treatment guidelines and practices related to the management of intracranial hypertension were identified through electronic databases: Medline and Cochrane library. Conservative interventions and surgical interventions are used when the clinical condition demands. Conservative interventions include osmotic therapy, analgesia, sedation and neuromuscular blocking agents, barbiturates, anti-seizure therapy and steroids. Head end elevation (15 to 30°), optimal hyperventilation, moderate hypothermia, avoidance of stimulations, fluid and electrolyte balance are some of the adjunct management strategies of ICP. CSF drainage, evacuation of mass lesion and decompressive craniectomy are the surgical interventions. Moreover, the success of ICP management depends on the control of ICP<20 mmHg (or age appropriate) and a CPP>50 (or age appropriate), as well as prevention of hypoxia and hypotension. Keywords: Increased ICP, ICP monitoring, ICP management

INTRODUCTION Intracranial pressure is defined as the total pressure exerted by the brain, blood, and CSF in the intracranial vault. Brain tissue, blood and cerebrospinal fluid (CSF) are the three intracranial constituents responsible for intra cranial pressure. Normal ICP varies with age as: 5–15 mmHg for adults and older children; 3–7 mmHg for younger children; 1.5–6 mmHg for term infants and sub atmospheric for neonates [1, 2]. Intracranial hypertension in adult can be defined as an ICP above 20 mmHg for more than 5 min. Increased intracranial pressure (ICP) or intracranial hypertension is a common medical emergency associated with both neurological and non-neurological disorders which demands early and prompt interventions. An ICP value of 20 to 30 mmHg represents mild intracranial hypertension. A

sustained ICP of greater than 40 mmHg indicates severe and life-threatening intracranial hypertension. Patients with ICP value greater than 20 to 25 mmHg require treatment in most circumstances. Increased ICP associated complications such as brain stem herniation and cerebral ischemia result in permanent neurological dysfunction or death [3].

CAUSES Increased ICP or intracranial hypertension may have a variety of etiologies. Based on the Monro-Kellie doctrine (Table 1), increase of any one of the three components (brain, blood or CSF) may elevate ICP. Causes can occur either solely or as combination [4]. ICP normally increases with activities such as suctioning, painful stimuli, coughing and other Valsalva maneuvers.

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Factors Associated with Nursing Student’s Intention to Leave Own Country Bharat Pareek1,*, Jyoti Mahajan2, Gurchetan Kaur3 1

Vice Principal, Saraswati Nursing Institute, Punjab, India National Consortium for PhD in Nursing, New Delhi, India 2 Staff Nurse, Medanta the Medicity, Gurgaon, Haryana, India 3 Department of Psychiatric Nursing, Saraswati Nursing Institute, Punjab, India 1

Abstract The worldwide migration of nursing professionals from low income countries to rich ones is very common as nurses fill the large number of vacancies in upper income country. A study was conducted to explore the various reasons (factors) associated with nursing students’ intention to leave own country. Data was collected from undergraduate nursing students, GNM, post basic and B.Sc., of Saraswati Nursing Institute, Punjab. Findings revealed that 63.23% of study participants would like to start their professional career abroad with a mean and SD score of associated reasons were 7.5±1.5 respectively. The most common reasons (factors) associated with nursing students’ intention to leave own country reported by the nursing students were better placement, money attraction, better career opportunities, job problems in India, poor status of nurses in India, job security in abroad, for higher education, corruption in nursing, family already settled in abroad, and want to marry with NRI. The study concluded that majority of the nursing students intend to start their professional career in developed countries for number of reasons which indicate high probability of brain drain among Indian professional nurses. Keywords: Brain drain, nursing student, nurse student, Punjab

INTRODUCTION Brain drain is a major concern of developing countries, especially in India. A recent study conducted by Indian institute of management, Bangalore shows that the students going for higher studies abroad has increased by 256% in the last 10 years, when 53,000 Indian students went for higher studies in 2000, whereas it raised to 1.9 lakh in 2010 [1]. Punjabis are now established migrant community whose migration roots can be traced back nearly 150 years. Total migration of Sikhs, Hindus and Muslims, is estimated at anywhere between 2 and 2.5 million but no precise estimates are available [2]. Nurses in low-income countries are migrating to wealthier countries in search of better salaries, improved working conditions, and more opportunities for further training, resulting in a "brain drains". The predicted additional nurses’ requirements of the developed world are large enough to deplete the supply of

qualified nurses throughout the developing world [3]. Estimates suggest 25,000 trained nurses across India leave every year for better paying jobs. Even the centre's notification of April 2015 banning private agencies from recruiting nurses for overseas jobs failed to make a significant impact in Maharashtra. The order has hit even traditional hubs like Kerala, which saw over a 60% decline in international placements last year (TOI May 9, 2016) [3]. While there are numerous studies, these studies have primarily focused on the views of and the push/pull factors affecting nurses already in practice. Push factors for health workers include poor remuneration and conditions of service, civil unrest, lack of opportunities for postgraduate training, feelings of lack of respect/value placed in health workers by country/system, and concern about poor governance and

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

Nonrandomized Trial on Assertive Training Module among Nursing Students Poonam Devi*, Bharat Pareek, N. Sujata Student, Department of Psychiatric Nursing. Saraswati Nursing Institute, Punjab, India Vice Principal, Department of Psychiatric Nursing, Saraswati Nursing Institute, Punjab, India Associate Professor, Department of Psychiatric Nursing, Saraswati Nursing Institute, Punjab, India Abstract Assertiveness is an important behavior for today’s professional nurse. As nurses move away from traditional subservient roles and perceived stereotypes it increases a nurse’s needs to behave in assertive manner. Time series non-equivalent control (quasi experimental) group design was adopted to determine the effectiveness of assertiveness training module among under graduate nursing students from Punjab. Assertiveness training module was developed. Baseline assertiveness level of study participants was assessed with Rathus assertiveness scale. Assertiveness training was given for subjects in experimental group. Participants in control group were used as counterfactual with waitlist intervention. Post-test assessment of assertiveness level of both the groups was done immediately after last training session and thereafter on 15th and 30th day. Subjects in experimental and control group were found homogenous at baseline (p>0.05). Test of significance revealed significant difference of mean assertiveness score between subjects in experimental and control group (P<0.05), whereas an estimated odd ratio for the intervention group was 0.044. The study concluded that the assertiveness training module was effective in building assertive behavior among nursing students, whereas estimated odds which continued to be non-assertive are 23 times higher among non-assertive subjects who did not get the intervention as among those who do. Keywords: Assertiveness training, program, assertive training module, assertiveness assertive behavior, nursing students

INTRODUCTION In everyday life situation and interaction, individuals develop patterns of responding to others. Some of these patterns include: watching other people, being positively reinforced or punished for a better way to respond, not developing the proper skills for a better response and consciously choosing a response style. The four types of response pattern are: Non-assertive, assertive, aggressive, and passive-aggressive to control and deal with our life in this present world of stress. We have to act in our best interests, stand up for ourselves without undue anxiety, express honest feelings comfortably, and exercise personal rights without denying the rights of others. This behavior is called assertive behavior whereas assertiveness is a core human behavior and is key to interpersonal relationships [1]. There are four response categories involved in

assertive behavior, namely: the ability to initiate, continue and successfully terminate conversations, the ability to say ‘no’; the ability to make requests or ask for favors, and the ability to express positive and negative feelings. Individuals who are not assertive do not respond in everyday interactions, and thus lack in spontaneity. Non-assertive individuals with expressive inhibitions lead unhappy lives. They generally experience a sense of emptiness and a feeling of dissatisfaction. Researchers have identified and specified verbal behavior that differentiates between assertive and nonassertive persons. Assertiveness is an important behavior for today’s professional nurse. As nurses move away from traditional subservient roles and perceived stereotypes, it is increasingly being recognized that a nurse needs to behave in assertive manner. Assertiveness is necessary for

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

A Descriptive Study to Assess the Awareness Regarding Preconception Care among Married Women Planning for Pregnancy with a view to Conduct Health Teaching Programme in Selected Rural Areas of Ahmedabad District Vandana Chauhan* Department of Obstetric Nursing, Ahmedabad Institute of Nursing Science, Ahmedabad, Gujarat, India Abstract A study to assess the awareness of women regarding preconception care among married women planning for pregnancy in selected rural areas of Ahmedabad district, Gujarat, India. Non-experimental approach was used with descriptive research design. The investigator used multistage simple random sampling technique for selecting 200 samples. A structured knowledge questionnaire was prepared to assess the knowledge of the samples. Structured knowledge questionnaires consisted of total 30 items such as diet, folic acid supplementation, smoking and alcohol, immunization and drugs, body weight, genetic counseling and other tests, contraception and birth spacing. The mean knowledge score was 10.70 (35.66%). The result suggested that there is a poor awareness regarding preconception care among married women. Keywords: Contraception, pregnancy, fetal development, health, women

INTRODUCTION Pregnancy is the most beautiful phase in a women’s life. It brings about emotional and physiological changes as well as poses extra demands on the body to give birth to a new baby. It is important to change habits before getting pregnant. The first few weeks of pregnancy are most important. In terms of fetal development, during which all major organs are forming in the baby. Preconception care allows a woman to be informed about pregnancy issues, risk of pregnancy to mother and fetus as well as education about its dangers and appropriate interventions. The term “preconception care” can be defined as optimizing health prior to attempting conception in the hope that a couple will conceive easily and attain a healthy pregnancy and birth [1]. Many women, however, are unaware of how their health before conception may influence their risk of having an adverse outcome of pregnancy. There is perhaps a greater need for preconception care because of high mortality rate, high morbidity rate, inadequate diet, a polluted environment, and

our often stressful lifestyles. Many women first consult their doctor or obstetrician only at around 9–10 weeks of pregnancy, which fails to target the women in the very early stage of pregnancy and embryo development [2].

OBJECTIVES 1.

To assess the awareness regarding preconception care among married women in selected rural areas of Ahmedabad district, Gujarat, India. To find out the association between pretest knowledge score of the samples with selected demographic variables.

REVIEW OF LITERATURE Review of literature helps the researcher to analyze what is known about the topic and to describe methods of inquiry used in earlier works including the success and shortcomings (Basavanthappa, 2007). It gives a broad understanding of the problem.

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

A Study to Assess the Knowledge and Practice of Married Women Regarding Prevention of Lower Reproductive Tract Infection at Bettahalsur, Bangalore Hetal Patel* Department of Obstetric Nursing, Ahmedabad Institute of Nursing Science, Ahmedabad, Gujarat, India Abstract A study was conducted to assess the knowledge and practice of married women regarding prevention of lower reproductive tract infection at Bettahalsur, Bangalore, India. A total of 100 married women were selected for the study in the age group of 20â&#x20AC;&#x201C;45 years by convenience sampling technique. The knowledge questionnaire consisted of 30 items and practise checklist consisted of 10 items. The result suggested that majority of married women had inadequate knowledge (93%) and practices (95%) towards prevention of lower reproductive tract infection. Keywords: Reproductive tract infection, prevention, STD, complications, inflammation

INTRODUCTION Reproductive tract infections are being increasingly recognized as a serious global health problem with impact on individual women and men. Serious long-term complications as a sequel to sexually transmitted diseases (STDs) in women, men, and newborns are well-documented. The presence of an STD, particularly ulcer-causing STDs, can enhance the acquisition and transmission of HIV. Efforts are being made globally to prevent, detect and treat adequately all reproductive tract infections. Pelvic inflammatory disease (PID) can develop and cause infertility, ectopic pregnancy and chronic pain. Global observation showed that most of the women (62%) aged between 15 and 45 years suffered with at least one or other reproductive tract infection. Most of the infections found among the women were cervicitis, vaginitis with purulent vaginal discharge. Recently, it has been shown that certain infections can increase the chances of HIV transmission [1]. Basic elements of reproductive health care of the World Health Organization (WHO) are responsible reproductive and sexual behaviour, widely available family planning services, effective maternal care and safe motherhood, effective

control of reproductive tract infection, prevention and management of infertility, and elimination of unsafe abortion and treatment of malignancies of reproductive organs [2].

OBJECTIVES This study endeavoured to: 1. Assess the knowledge and practice regarding prevention of lower reproductive tract infection among married women. 2. Find the relationship between knowledge and practice of married women regarding prevention of lower reproductive tract infection. 3. Find the association between knowledge regarding prevention of lower reproductive tract infection of married women and selected demographic variables.

REVIEW OF LITERATURE Review of literature is based on an extensive survey of books, journals and international nursing indices. It provides basis for selection and formulation of the problem, justifies the need for the study, develops the proper conceptual model for the study, throws light on the feasibility of the study, provides

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X (print) Volume 6, Issue 3 www.stmjournals.com

A Descriptive Study on Prevalence of Health Problems, their Treatment-Seeking Behavior and Preventive Measures among Selected Class C Employees of PGIMER, Chandigarh, 2015–2016 Sandhya Ghai1, Mahesh Devnani2, Neena Vir Singh1, Suresh Kumar Bamania1,*, Amardeep Kaur1, Harpreet Kaur1, Kirti Thakur1, Navneet Kaur1, Pushpreet Kaur1, Shivani Thakur1 1

National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India 2 Department of Administration, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Abstract Health is the state of wellbeing that people define in relation to their own values, personality and lifestyle. Thus, there should be awareness regarding prevalent diseases, common health problems and their treatment. Prevalence refers to the total number of individuals in a population who have a disease or health condition at a specific period of time, usually expressed as a percentage of the population. Treatment-seeking behaviour refers to "sequence of remedial actions that individuals undertake to rectify perceived health" and preventive measures are referred to as doing something good to minimise and reduce level of illnesses or problems. A descriptive quantitative research design was used to conduct the study to assess the prevalence of health problems, their treatment-seeking behavior and preventive measures among class C employees of PGIMER, Chandigarh, India. Systemic random sampling technique was utilized for this study. A structured questionnaire and biophysical assessment was used for data collection. Total 150 study participants were assessed. Majority (36.6%) of them were in the age group of 20–30 years, where male subjects were 65.3%. Contraceptives were used by majority (85.30%) of people and 78% were aware about the routes of HIV transmission. About 72.70% did not know much about vaccination and were not vaccinated for hepatitis B. Out of 29 reproductively active women, 23 had regular menstrual flow. Only 31.25% of total women participants performed breast self-examination. A total of 69.30% of the participants had normal BMI; 63.33% of participants exercised regularly, and 53.69% of them exercised for an average duration of 20 min. About 97.34% participants have sitting hours of 5–8 h per day. Twelve percent of participants were previously diagnosed with hypertension, 25.35% participants suffered from backache, and eye problems were prevalent in 50.70% population. In relation to their treatment-seeking behaviour, administration of selfmedication of allopathic medicine was by 66% of the participants and 58.7% received benefits from the other modalities (Ayurveda, Homeopathy, Yoga etc.). About 24% participants were very much influenced by advertisements, treatment methods and healthcare centres in their decision making hence media plays a very important role in health promotion. The treatmentseeking behavior was average and preventive measures taken were also average; so still there is need to create awareness regarding better lifestyle, good dietary pattern and health practices. Keywords: Health problems, treatment-seeking behaviour, preventive measures

INTRODUCTION Each person has a personal concept of health. Pender et al. (2006) defined health as the actualization of inherent and acquired human

potential through goal-directed behaviour, competent self-care and satisfying relationships with others while adjustment are made as needed to maintain structural integrity

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X (print) Volume 6, Issue 3 www.stmjournals.com

A Study to Assess the Knowledge and Prevalence of Iron Deficiency Anemia among Adolescent Girls in a Selected College of New Delhi Sarita Ahwal* Department of Medical and Surgical Nursing, Rufaida College of Nursing, Jamia Hamdard, New Delhi, India Abstract The aim of the present study was to assess the knowledge and prevalence of iron deficiency anemia among adolescent girls in a selected college of New Delhi, India. Using quantitative approach, a cross-sectional survey was conducted among adolescent girls in the age group of 15–19 years. Using convenient sampling, 100 adolescent girls were selected. Data were collected using subject information sheet, knowledge assessment questionnaire, and Hemocheck to measure hemoglobin (Hb) level. Anemia, i.e., Hb <12 g/dl was found in 70% of the study samples. However, majority of the adolescent girls had average-to-good level of knowledge. Despite having knowledge about anemia, majority of the adolescent girls suffer with anemia. Keywords: Prevalence of anemia, adolescent girls, iron deficiency anemia, knowledge of anemia, hemoglobin

INTRODUCTION Iron-deficiency anemia is the most common type of nutritional anemia, which results from long-term negative iron balance and is responsible for approximately 50% of all anemia [1]. In India, it poses a huge burden on health. Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618–621) million in the year 2013 [2]. As documented by various studies, in India, 60– 90% of adolescent suffer from anemia [3]. Girls in the period of later school age and early adolescence are prone to develop iron deficiency. Adolescence is a phase of rapid growth and development during which physical, physiological, and behavioral changes occur. They constitute more than 1.2 billion worldwide and about 21% of Indian population [4]. In this period, more nutritious and healthy diet is required. Accelerated development, hormonal changes, malnutrition, and starting of menstrual periods in girls are the major causes of iron-deficiency anemia during adolescence, which may also lead to impaired perception and learning difficulties [5]. Iron deficiency leads to many nonhematological disturbances which include growth and development, depressed immune function in infants, reduced physical work

capacity, and decreased cognitive function in both infants and adolescents [6, 7].

METHODOLOGY Using quantitative approach a cross-sectional survey was conducted at the Rufaida College of Nursing, New Delhi, India from November 2015 to December 2015. The objective of the study was to assess the prevalence and knowledge of iron deficiency anemia among adolescent girls. Ethical Consideration Ethical clearance for conducting the study was obtained from the Ethics Committee, Jamia Hamdard, New Delhi, India. Consent was taken from all the study subjects. The information was dealt with confidentiality. No charges were taken for hemoglobin (Hb) checkups. Findings were conveyed to the participants. The participants were also given informational booklets to modify their lifestyle and were educated to keep a check on their Hb levels as appropriate.

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Journal of Nursing Science & Practice ISSN: 2249-4758(online), ISSN: 2348-957X(print) Volume 6, Issue 3 www.stmjournals.com

Nonpharmacological Methods Used in the Management of Pain Caused by Peripheral Intravenous Catheters Dilek Yılmaz1,*, Yurdanur Dikmen2 1

Department of Nursing, School of Health, Uludag University, Bursa, Turkey Department of Nursing, School of Health, Sakarya University, Sakarya, Turkey

Abstract Peripheral intravenous catheters are one of the most important tools of modern medical treatment. Although they are commonly used in clinical practice, it is reported that this is painful and uncomfortable for patients. In the previous studies, mostly pharmacological methods have been used to control the pain and discomfort experienced when peripheral intravenous catheters were used. However, although pharmacological methods are effective in controlling pain, they also have disadvantages for patients such as the likelihood of side effects, and additional time and cost. Therefore, there is a need for methods of controlling pain and discomfort, which are cheap, quick and easy to use, and have no possibility of side effects. Nonpharmacological methods are grouped as peripheral treatments, cognitivebehavioral therapy, and treatments other than these methods. Mostly cognitive-behavioral therapy and peripheral techniques have been tried in controlling the pain caused by peripheral intravenous catheters. These techniques have been used to a great extent on pediatric patients, where it was found that blowing up balloons, seeing flashing lights, listening to music, squeezing a stress ball, watching animation shows, or using a kaleidoscope were effective as methods of attracting attention in reducing the pain due to intravenous catheters. In addition, it has been found that techniques such as the valsalva maneuver, carried out by blowing into a sphygmomanometer and coughing, buzzy usage, and ice application were also effective. The aim of this review study was to investigate nonpharmacological methods and their effectiveness in controlling the pain experienced during peripheral intravenous catheterization. Keywords: Nonpharmacological methods, pain, peripheral intravenous catheters

INTRODUCTION Peripheral intravenous catheters compose one of the important tools of modern medicine treatment [1–3]. Peripheral intravenous catheters’ applications are performed in many clinical and emergency services [4, 5], especially in the invasive procedures applied commonly by nurses [6–8]. Peripheral intravenous catheters’ applications are commonly performed to sustain fluid and electrolyte balance, apply medicine, give blood and blood product and provide parenteral nutritional support [2, 9]. In the literature, it is mentioned that peripheral intravenous catheters’ applications are painful and annoying for patients [3, 10–12]. Besides, the pain occurs during peripheral intravenous catheters’ applications could increase the anxiety level of patients because of their existing pathologies and this situation could affect homeostasis [11, 13]. In this direction, it

is emphasized that the pain and annoyance related to peripheral intravenous catheters’ applications should be evaluated carefully, several measures should be taken and effective method should be applied [2, 11]. In the studies conducted till date, pharmacological methods including Emla cream, ethyl chloride, lidocaine application are commonly used by the doctors in order to control the pain and annoyance occurring during peripheral intravenous catheters’ applications [14–19]. Although pharmacological methods are effective in controlling the pain during peripheral intravenous catheters’ application, they have few disadvantages such as side effect possibilities with regards to patient, and additional time and cost [3, 10].

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