Journal of Nursing & Care

Effective communication among healthcare providers is the key driver for the success of the healthcare system. All the decisions related to patient care depend on effective communication among healthcare providers. Communication and teamwork are the backbones of the organization and helps to safeguard patients’ safety. The study aimed to identify the contributing factors to the communication gap between doctors and nurses at selected private hospitals in Malaysia. The study used a qualitative method with an explorative and descriptive design to elicit the experience of 24 staff nurses from six private hospitals in Kuala Lumpur, Malaysia. A semi-structured interview was conducted to collect the data. The data were analysed using Colaizzi's method for thematic data analysis. The findings of the study suggested three categories as the factors to be responsible for the nurse-physician communication gap as perceived by nurses. The three categories are nurses work readiness; work environment and physician attributes. The respondents also suggested measures to overcome the communication barrier among nurses and physicians. In conclusion, a healthy nurse-physician communication is a vital factor in determining patient safety and quality of care.

Asthma is one of the most common chronic diseases worldwide. Although asthma is a major cause of patient disability and in rare cases causes premature death and it has a profound impact on all aspects of a patient's life. The aim of this study was to evaluate the effect of a nursing intervention program on nurses' knowledge and practices and outcomes for patients diagnosed with bronchial asthma. A quasi experimental research design with pre and post-test assessment was used on 30 participants of nurses working in the Chest ICU and the Chest Department at Zagazig University Hospitals, Egypt and 30 adult patients diagnosed with acute severe bronchial asthma under their care. Structured interview tool was used to assess nurses' knowledge, an observation checklist for their practice and the Asthma Severity Assessment Scale and Breathlessness Scale for patients. The researcher developed nursing intervention program based on analysis of assessment data and using pertinent literature to teach nurses guidelines for dealing with patients diagnosed with acute severe asthma. This was delivered to nurses in 12 sessions. Evaluation was done immediately (post-test) and three months after implementation (follow-up), along with evaluation of the patients. The results showed marked deficiencies in nurses’ knowledge and practices before the program, with significant improvements at the post and follow-up evaluations, associated with amelioration of the severity of asthma and dyspnea among studied patients. Therefore, a relatively short-term in service training programs for all nurses working in the Chest ICU and the Chest department is implemented to enable nurses to update their knowledge and practice. Evidence based protocols for patients diagnosed with bronchial asthma should be routinely implemented and evaluated.

Performance evaluation is a continuous process in assessing the employee’s contribution to the organization. The aim of performance evaluation is to achieve an equitable capacity of the employee’s contribution to the workplace. In nursing, the evaluation performance encompasses cognitive skills; affective and psychomotor domains. The aim of this study was to evaluate the new nurse graduates' performance who had been trained within an environment of ‘everything is new to everyone’ in one of the teaching hospitals. A comparative descriptive study was conducted with 113 staff nurses as after 2 years of graduation. Work performance domains evaluated are; punctuality, physical appearance, attitude and commitment to work, service excellence, positive relationship, communication skills, and leadership. Results had shown 76.02% of the new nurse graduates’ performance was excellent as evaluated by the 1st evaluators. Similar results were obtained from the overall evaluation of the 2nd evaluators. However, in some aspect of the overall evaluations, there was an inconsistency that contradicts the evaluation of both evaluators. A system will run accordingly if it is well communicated and had mutual consensus between evaluators who regard performance evaluation is rather a continuous process even in a difficult environment when everything is new to everyone.

Background: Although institutional delivery is the corner stone to reduce maternal death and improve child health, institutional delivery in Ethiopia is the lower in the world where only 26% of women attained skilled delivery. This study aimed to identify factors determininging the utilization of delivery services among women in Farta District. Method: A community based cross sectional study design was conducted from March 1-30, 2017. Multistage sampling was used to select women. Data were collected from a sample of 779 women using structured questionnaire, entered in to EPI-info version 7.2, and analysed by SPSS Version 23. Frequencies, percentages and summary statistics were computed to describe the study population. Logistic regression was computed to identify the associated predictors with skilled delivery service utilization. Statistical level of significance was declared at p<0.05. Results: The prevalence of institutional delivery was 64.4% (95% CI=61, 67.4). A multivariable logistic regression model indicated that family size, availability of transport, planned pregnancy, information about place of delivery, participation of women monthly health conference (PWMHC), information about exempted service, and having antenatal care (ANC) follow up during their last pregnancy were found to be significantly associated with institutional delivery service utilization. Conclusion: The attendance of women for institutional delivery care is good but below the national plan. Maternal care information, women monthly conference and behavioural change for planning pregnancy should be taken due attention to mobilize mothers towards skilled birth attendance. Allocation of more resource to the program and increasing availability of transportation during labor is also commendable. Improving mother’s ANC follow up attendance in resource limited regions is warmly suggested.

Background: Adolescent’s sexual abuse is any interaction between adolescents and an adult (or another adolescent) in which the adolescents is used for the sexual stimulation of the perpetrator or an observer. Sexual abuse can include both touching and non-touching behaviors. Abusers often do not use physical force, but may use play, deception, threats, or other forms of coercion to engage adolescents and maintain their silence.
Objective: The objective of this study was to assess prevalence and associated factors of adolescents sexual abuse among adolescents in high school, Nekemte town, East Wollega Zone, Oromia Regional State, Ethiopia, 2017.
Methods: School based cross sectional study was conducted in high school of Nekemte town, using systematic random sampling technique from March 1st to 15th, 2017. Data was collected from 377 adolescent students using structured, pre tested and self-administered questionnaire. After data collection, data was cleared, coded, checked and entered in to computer software SPSS version 20.0. Univariate, analysis was performed for frequency and percentage. Binary logistic regression analysis was done to identify factors associated with sexual abuse and these factors were taken in to multivariate analysis with 95% confidence interval. Result: Among study participants involved in the study 126 (33.4%) were sexually abused at least once in their life time and the remaining 251 (66.6%) were not sexually abused. Factors of sexual abuse associated significantly were grade attending, Fathers occupation and Mothers’ education and occupation positively associated with sexual abuse of adolescents while drinking alcohol and had sexual intercourse associated inversely.
Conclusion and recommendation: The prevalence of sexual abuse is high and needs every one’s attention on its reduction. Awareness creation for families and communities on sexual abuse and education for adolescents on short and long impact of sexual abuse is recommended.

Background: Burnout has been defined as an occupation stress, result of continues and long-term stress exposure, particularly related to King Saud Medical City (KSMC) in Saudi Arabia. Of burnout among critical care nurses at King Saud Medical City (KSMC) in Saudi Arabia has not been explored in previous research. Psychosocial factor at work. Burnout has significant effect on patient care and nursing performance.
Objective: This study aims to explore level of burnout among critical care nurses at King Saud Medical City (KSMC) in Saudi Arabia-Riyadh Methods: A descriptive cross sectional design was utilized using a self-reporting questionnaire two sections contain demographic and Meslach burnout inventory (MBI) tool, obtain information from ICU nurses about level of burnout by measuring emotional exhaustion, personal accomplishment and depersonalization. The questionnaire was distributed to 300 nurses employed in King Saud Medical City (KSMC), which is one of the biggest tertiary hospitals in Riyadh, Saudi Arabia. 270 nurses responded to the questionnaire (90% response rate).
Results and conclusion: The results showed sever level prevalence 65.9% of burnout among critical care nurses at King Saud Medical City (KSMC) in Saudi Arabia-Riyadh. Simple random method from four critical care department T1A1, T1A2, T1B1 and TRCU. The majority of the nurses were females, where (97%), median age 30.9- year, majority of staff (82.2%) their age range 25 yr -34 yr, around 60% married, 81.5% bachelor degree. Most of sample were staff nurse78.5%, staff selected in 68.5% of sample experience less 5 yr in hospital and their total ICU experience 48.5%. More than 5 year and less than 10 yr. 85.9% of them don’t have any medical illness. 56.3% of sample they are not satisfy about their salaries most of them complain from non-financial reason. 67% of them satisfy about 12 h duty most Of them less than 5 year experience in KSMC but nurses more than 5yr they prefer return to 8 hrs. Shift they bind this with ICU workload.

Background: Studies show that certainty of death may affect time perception and the meaning attributed to time. The central interest of this research is the connection between the perception of time and fairy tales. The aim of the study was to explore the fairy tale method in their delivery of palliative care and how this work is related to the concept of time.
Methods: A focus group interview conducted with a team delivering the service in Russia forms the basis of the exploration of experiences of working with a Fairy Tale method in palliative care. The data generated from the focus group are analyzed using a phenomenological-hermeneutic method. This involves reading the data at three levels: naïve reading, structure analyses and complete interpretation.
Results: From the analysis, it emerged that the fairy tale method relates to 1) a multidirectional time continuum 2) an intensification of the perception of time and 3) the alertness of time. Together, these three themes act together to form a “time machine” which regulates both the perceived speed at which time passes, awareness of the quality of time, and the intensity of the perception of time within the fairy tale.
Conclusion: The ‘fairy tale tool’ promises the possibility of transforming the experience of time for hospice patients, helping them to mediate perceived time and calibrate awareness. The findings are discussed with regards to the potential applications of the fairy tale tool beyond palliative care: It is suggested that it could be extended into a more existential instrument that might help larger population to deal with the postmodern living conditions and extreme hurriedness.

Objective: We investigated the association between stroke severity and pre-hospital delay of patients with an acute ischemic stroke (AIS).
Method: A consecutive 1,412 patients with AIS enrolled in the acute stroke registry were included in the final study. Stroke severity was assessed by National Institute of Health Stroke Scale (NIHSS) score. A pre-hospital delay between less than 3 h and 3 h or more was compared using Pearson's chi-square for categorical variables and Student's t-test or Mann-Whitney U test for continuous variables, as appropriate. Association between initial NIHSS score and pre-hospital delay was plotted with Spearman’s correlation analysis. We used the analysis of variance or Kruskal-Wallis test and chi-squared test to compare the baseline characteristics according to NIHSS tertile. We analysed the variables associated with the higher shift of NIHSS tertile using an ordinal logistic regression analysis.
Results: Increased stroke severity decreased the pre-hospital delay (Spearman’s rho=-0.216, p<0.001). Age (common odds ratio (cOR), 1.03; 95% confidence interval (CI), 1.02-1.03; p<0.001), history of previous stroke (cOR, 1.56; 95% CI, 1.25-1.94; p<0.001) and pre-hospital delay ≥ 3 h (cOR, 0.48; 95% CI, 0.39-0.59; p<0.001) were associated with higher shift of NIHSS tertiles in univariable ordinal logistic regression analyses. In multivariable model, pre-hospital delay ≥ 3 h is a negative predictor for higher shift of NIHSS tertile (cOR, 0.49; 95% CI, 0.39-0.61; p<0.001).
Conclusion: As the stroke severity increased, onset-to-hospital arrival time was decreased in AIS patients. Therefore, the findings suggest the need for development of individualized educational programs for each stroke patient.

Aims and objective: This article seeks to review the experience of registered nurses providing care for dementia patients including theoretical perspectives that have been used to provide care for people with dementia. Background: Nurses have a vital role in providing special and personalized care for people with dementia and also their family members. However, there is little knowledge about the experiences of nurses providing care for people with dementia in Thailand. Design: An integrative literature review. Method: This literature review of 19 articles was undertaken to encapsulate what research has done in the experience of nurses providing care for people with dementia. Results: Four themes related to the nurses’ experiences of providing care for people with dementia included encountering with painful emotions, working under severe conditions, meeting holistic care needs, and experiencing inadequate knowledge. Factors contributing to appropriate care for people with dementia and barriers to meet the optimal care were identified in this article. Conclusion: Nurses experienced struggling with painful emotions and working under difficult circumstances and there was the need for meeting spiritual care needs of patients. Nurses identified that a lack of knowledge of dementia and the need for improved effective communication when they provided care for a group of these patients and their family members. Relevance to clinical practice: Nurses seek to understand nurses’ experiences of providing care for people with dementia may help them to utilize positive care experiences to practice. Those nurses should consider to some experiences that may be factors to achieve and hinder the optimal care.

Background: Wound infection is a common complication of caesarean section and may lead to maternal sepsis, increased health care costs, prolonged hospital stay and negatively influences the outcome of the patient. Even though the extent of the problem is expected to be high in Ethiopia, it was not studied well. Objective: To assess the magnitude of post caesarean section surgical site infection and its associated factors among mothers who underwent caesarean section in Mizan Tepi university teaching hospital, south west Ethiopia, 2017. Methods: Cross-sectional study design was conducted in Mizan Tepi university teaching hospital from March 10-30, 2017. A total of 325 records of mothers were reviewed based on CDC criteria for surgical site infection after selecting the cards by simple random methods. Data were entered in epidata version 3.1and analysed with using frequency, percentage and binary logistic. Result: Overall post caesarean section surgical site infection rate was 12.9%. Rupture of membrane <24 h (AOR=0.35, 95% CI: 0.129, 0.897), pre-operative hematocrit count of <30% (AOR=2.598, 95% CI: 1.125, 6.003) and post-operative admission for less than 8 days (AOR=0. 109, 95% CI: 0.043, 0.276) were found to be independent predictors of post caesarean section surgical site infection. Conclusion and recommendation: Post caesarean section surgical site infection was found to be high in Mizan Tepi University teaching hospital. Rupture of membrane <24 h, pre-operative hematocrit count of <30% and postoperative admission for less than 8 days were found to be significant factors for post caesarean section surgical site infection. Effort should be made to prevent prolonged rupture of membrane and accessing and proper counselling on the appropriate utilization of iron folate at antenatal care setting should be stressed.