Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Objective:Rheumatoid arthritis(RA)requires comprehensive management.Structured nursing protocols may enhance outcomes,but evidence is limited.This study evaluated the effect of a structured nursing protocol on RA outcomes.Materials and Methods:In this one-group pre-post study,30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education,psychosocial support,and self-management promotion.Assessments included clinical evaluation of joint counts,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and patient-reported Arthritis Self-Efficacy Scale(ASES),Health Assessment Questionnaire(HAQ),Visual Analog Scale(VAS)for pain,and Hospital Anxiety and Depression Scale(HADS).Results:The study demonstrated significant improvements in both clinical-and patient-reported outcomes.Joint count decreased from 18.4±4.2 to 14.2±3.8(P<0.001),ESR from 30.1±6.8 mm/h to 25.5±6.8 mm/h(P<0.01),and CRP levels from 15.2±3.6 mg/L to 11.8±2.9 mg/L(P<0.01)postintervention.Patient-reported outcomes showed a marked increase in ASES score from 140±25 to 170±30(P<0.001)and reductions in HAQ from 1.6±0.4 to 1.3±0.3(P<0.01),VAS pain score from 7.8±1.7 to 6.2±1.2(P<0.001),and HADS anxiety and depression scores from 11±3 to 8±2(P<0.05)and 10±2 to 7±1(P<0.05),respectively.Conclusion:A structured nursing protocol significantly improved clinical disease activity,physical functioning,pain,self-efficacy,and emotional well-being in RA patients.A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

Effectiveness of simulation-based learning regarding management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students:A quasi-experimental study

Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.

Exploration moving beyond medical facility walls:opportunities,challenges and attitudes of midwives towards planned homebirth:a qualitative

Background:The establishment of Saudi Vision 2030 has led to a shift from obstetric care to midwifery-led care in maternity care,giving rise to planned home birth(PHB).This study may enable midwives to carry out PHB and achieve the goals of the Saudi health vision.The general aim is to explore Saudi midwives’attitudes towards the PHB,opportunities and challenges associated with PHB implementation in Saudi Arabia.Methods:We employed a qualitative study design and conducted interviews using open-ended questions with 19 Saudi midwives recruited from thirteen health regions.Thematic analysis was manually performed to analyze the qualitative data.Results:Thematic analysis revealed seven major themes:midwives as care providers in PHB,health institutions,academic institutions,national policy for PHB,Women’s health status,socio-economic and physical environment suitability,and maternal and neonatal health outcomes.However,Saudi midwives would exhibit a favorable attitude towards PHB if decision-makers from the Ministry of Health and the Ministry of Education addressed the challenges and promoted opportunities for providers,organizations,and the population.Conclusion:The findings of the thematic analysis shed light on several positive aspects,including job opportunities and high financial incomes for midwives.However,they also revealed challenges such as a shortage of midwifery staff,a scarcity of midwifery academic programs,and an ineffective administrative support system for midwives.Integrating both sets of findings enhances the understanding of the challenges and opportunities of planned home birth in Saudi Arabia from various perspectives,capturing the breadth and depth of the obtained data.

Transcultural adaptation of Odia version of health-related kidney disease and quality of life-36 instrument

Objective:The study objective was to translate,validate,and test the reliability of the original kidney disease and quality of life-36(KDQOL-36^(TM))instruments in Odia.Materials and Methods:A cross-sectional design with a purposive sampling technique was used.According to RAND Corporation guidelines,initially,the items of the KDQOL-36^(TM)questionnaires were translated into Odia by two independent,bilingual,professional translators,and then back-translated to English,followed by tryout and field testing.The experts validated the KDQOL-36^(TM)instrument review committee for review related to kidney health conditions.The tool was implemented among 180 patients undergoing“maintenance”hemodialysis.The following tests evaluated reliability and validity:test-retest reliability with Cronbach’s alpha correlation(stability),(reliability)internal consistency,and contents validity index.Results:The Cronbach’s alpha value and intraclass correlation coefficient(ICC)score of all five domains,namely“physical component summary,mental component summary(MCS),the burden of kidney disease,symptoms and problems of kidney disease,and effects of kidney disease”of both KDQOL-36^(TM)English and Odia(KDQOL-36-E^(TM)and KDQOL-36-O^(TM))version,recommended excellent homogeneity.A high positive correlation(r=0.998)was found between the Odia version of KDQOL-36^(TM)and the English version KDQOL-36^(TM)questionnaire.The ICC score ranges from 0.889 to 0.997 at a 95%confidence interval for test-retest reliability,and Cronbach’s alpha was 0.832.Conclusion:This study explores the Odia version of KDQOL-36^(TM)psychometric properties,depicted at an acceptable level of internal consistency.The KDQOL-36-O^(TM)instrument is a valid and reliable tool for assessing the kidney disease-related quality of life in Odia-speaking hemodialysis patients.

Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction

Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L.

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

Objectives: Comprehensive nursing assessment,as the first step in the nursing process,involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process.The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.Methods: A randomized controlling design was conducted.Of 84 undergraduate nursing students,42 students were allocated to the intervention or control group.In clinical education,a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process,while the control group received traditional methods.The data were gathered using a demographic information questionnaire,skills in nursing process development checklist,and attitudes towards nursing process questionnaire.Results: The average scores for students' attitude and skills in developing nursing process in the intervention group were greater than those of the control group.Conclusion: Applying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.

The barriers of joining in vitro fertilization programs among infertile couples in developing countries:A scoping review

Objective:To determine the barriers of joining in-vitro fertilization(IVF)programs among infertile couples in developing countries.Methods:This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed,ScienceDirect,EBSCO,ClinicalKey,and Cochrane Library from inception until December 31,2021.Additional search strategies were snowballing literature search and citation tracking.Results:Eleven articles were included in the scoping review.The cost was the greatest barrier of joining IVF program.Limited access and lack of assisted reproductive technology centers,few qualified infertility trained staff,insufficient government support,low priority in government policy,along with sociocultural factors,such as religion and false beliefs or myths were also majorly considered to be associated obstacles.Conclusions:The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.

Prioritizing the efforts:lived experiences of family when taking care of people with cancer

Objective:Cancer has one of the highest disease mortality rates.Families are very important in the treatment of people with cancer.By using a phenomenological design,this study aimed to explore the experience of families in caring for a person with cancer and to identify the needs of these families.Methods:First,eight interviews were under taken with family members selected through a purposive sampling method.Then,another three interviews were conducted for data validation.The collected data were analyzed using the framework method of analysis.Results:The core theme,“Prioritizing the efforts:Being aware of the best we could do for our family,”reflected family’s experiences of caring for a person with cancer and was underpinned by five themes:“Decisions to make,”“Keeping up the good support,”“Acknowledging the others’contributions,”“Assisting my family to alleviate the disease,”and“Adapting to the current situation.”Conclusions:The results suggest that building mutual trust and communication between family and healthcare professionals is vital in decision-making for people with cancer.Family may also work with the person in fulfilling their needs,without disregarding the needs of the family.When suppor ting the needs of people with diabetes,the family requires appropriate information,and thus,healthcare professionals wisely select which information can help the family make a decision regarding the treatment.After administering the treatment and providing information for people with cancer and their family,asking for feedback is required for evaluation.

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

Self-management of osteoarthritis while waiting for total knee arthroplasty during the COVID-19 pandemic among older Malaysians

BACKGROUND The study sought to understand the self-management strategies used by patients during the postponement of their total knee arthroplasty(TKA)procedure,as well as the associations between the length of waiting time,pain,and physical frailty and function.The study focused on individuals aged 50 years and above,as they are known to be more vulnerable to the negative impacts of delayed elective surgery and rehabilitation.This study hypothesizes that delayed TKR due to coronavirus disease 2019(COVID-19)will bear negative effect in self-management,pain,and physical frailty and function in older adults.AIM To investigate the effects of COVID-19 pandemic on self-management,pain,and physical function in older adults awaiting TKA in Malaysia.METHODS This cross-sectional study has the data of participants,who matched the criteria and scheduled for TKA for the first time,extracted from the TKA registry in the Department of Orthopaedics and Traumatology,Hospital Canselor Tuanku Mukhriz.Data on pain status,and self-management,physical frailty,and instrumental activities daily living were also collected.Multiple linear regression analysis with a significant level of 0.05 was used to identify the association between waiting time and pain on physical frailty and functional performance.RESULTS Out of 180 had deferred TKA,50%of them aged 50 years old and above,80%were women with ethnic distribution Malay(66%),Chinese(22%),Indian(10%),and others(2%)respectively.Ninety-two percent of the participants took medication to manage their pain during the waiting time,while 10%used herbs and traditional supplements,and 68%did exercises as part of their osteoarthritis(OA)self-management.Thirty-six participants were found to have physical frailty(strength,assistance with walking,rising from a chair,climbing stairs,and falls questionnaire score>4)which accounted for 72%.Increased pain was associated with physical frailty with odds ratio,odds ratio(95%confidence interval):1.46(1.04-2.05).This association remained significant even after the adjustment according to age and self-management.CONCLUSION While deferring TKA during a pandemic is unavoidable,patient monitoring for OA treatment during the waiting period is important in reducing physical frailty,ensuring the older patients’independence.

Occupation-related airborne diseases: Management and prevention of tuberculosis among nurses working in Ekiti State University Teaching Hospital

Objective:More health workers die from infectious diseases such as tuberculosis(TB)than from any other infectious agent,so the current study is designed to assess TB treatment and preventive measures as they relate to nursing care practice.Materials and Methods:A cross-sectional study was conducted among 82 nurses from December 2022 to January 2023.The data were collected through a self-developed questionnaire and analyzed by frequency table and analysis of variance(ANOVA)statistics.Results:The researchers found that nurses have sufficient knowledge on Infection Prevention and Control(IPC)policy,but not all nurses follow this management protocol,and the reason for their action is addressed in this study.The management and preventive measures used by the participants were identified as:proper cough etiquette/hygiene,working in a well-ventilated area,use of mask,appropriate disposal of used items and so on was reported.Moreover,this study also discovered that there is a positive correlation between nurses who had received training in IPC policy and their use of airborne preventive measures for TB patients(F=1.87,P=0.002)as well as a positive correlation between the availability of resources and their adherence to the proper use of airborne preventive measures when caring for TB patients(F=1.96,P˂0.001).Conclusion:We proposed infection and control training for nurses and adequate equipment supplies to the TB ward which are required in quick TB diagnosis,and must be carried out on a regular basis by health-care personnel,for efficient nursing practice.Ensuring proper safety equipment and isolation units should be available and assessable for nurses or other health workers showing sign or symptoms of TB.Similarly,it is necessary for government to put in place the control and regulations that will safeguard nurses and mandate them to adopt TB prevention protocols,which will aid in lowering the prevalence of TB among nurses.

A comparison of the effect of Vitamin D and Vitamin E supplementations,alone,and in combination,on reducing the intensity and duration of dysmenorrhea in women:A randomized controlled trial

Objective:The aim of this study is to compare the effect of Vitamin D and Vitamin E supplementations,alone,and in combination,on reducing the intensity and duration of dysmenorrhea in women who were referred to the Kowsar gynecological clinics of Shahid Motahari Hospital of Urmia University of Medical Sciences.Materials and Methods:A double-blinded clinical trial was conducted on 112 women with dysmenorrhea who were randomly allocated into the four study groups.Finally,100 women complete the study and received capsules containing a placebo(n=25),1000 IU of Vitamin D(n=25),400 mg of Vitamin E(n=25),and 1000 IU of Vitamin D+400 mg of Vitamin E(n=25)every 24 h for 2 consecutive months at the beginning of the menstrual period.The pain intensity and duration among groups were compared before and after the intervention.Results:The mean menstrual pain duration in all three experimental groups(Vitamin E,Vitamin D,and the combination of them)was lower than the placebo group(all P<0.05),and the mean pain intensity scores in all three experimental groups were significantly lower than the placebo group(all P<0.05).The results(means)for all of the drugs administered at the end of the 2nd month were better than the 1st month(all P<0.01).Conclusions:Vitamin E and Vitamin D,as well as their combination,are recommended as an effective and safe treatment for the management of the complications of dysmenorrhea.

Effects of different acupuncture methods combined with routine rehabilitation on gait of stroke patients

BACKGROUND Stroke refers to a group of cerebrovascular diseases associated with organic braininjury. It is characterized by the sudden and rapid onset of focal or diffusedysfunction. In recent years, in addition to routine treatment, Chinese medicineacupuncture has been administered to patients with hemiplegia, and it can beconsidered a new treatment for rehabilitation.AIM To investigate the effects of eye acupuncture needle retention and bodyacupuncture combined with routine rehabilitation on gait performance andplantar pressure in patients recovering from stroke.METHODS Thirty-two stroke patients who met the inclusion criteria were randomly dividedinto an experimental group and a control group, with 16 patients in each group.Both groups underwent routine rehabilitation. The experimental group wastreated by eye acupuncture needle retention, and the control group was treated bybody acupuncture. Before and after 4 wk of treatment, both groups underwentkinematic and plantar pressure synchronous tests to assess gait performance.RESULTS The step length, gait speed, step frequency, joint angles of the lower limbs, andground reaction force impulse in the anterior region of the affected foot in bothgroups significantly increased from before to after treatment (P < 0.05);the center of mass displacement, peak pressure values, and impulse in the anterior region ofthe healthy foot and posterior regions of both the affected and healthy feetsignificantly decreased from before to after treatment (P < 0.05). The patients inthe experimental group showed greater improvement in the following parametersthan the control group: Step length, gait speed, step frequency, lower extremityjoint angles, center of gravity displacement, and peak pressure values andimpulse in the anterior and posterior regions of both the affected and healthy feet(P < 0.05).CONCLUSION Eye acupuncture needle retention and body acupuncture combined with routinerehabilitation can effectively improve the gait performance of patients recoveringfrom stroke. Between these two treatments, eye acupuncture needle retentioncombined with routine treatment is better than body acupuncture, and it can beconsidered a practical and effective clinical treatment.

Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention

The purpose of this study was to examine the relationship between daily activities and sleep durations for patients following elective percutaneous coronary intervention (ePCI) and diagnosed with ischemic heart disease (IHD) after discharge to their homes. The actigraph data were used to collect data from twenty five patients. The duration of night-time sleep (minutes from the start to end of night-time) and actual night-time sleep duration (total sleep duration excluding wake-up durations of night-time) on the seventh day after discharge were divided into three groups;less than 360, 360 to 480, and more than 480 minutes (short, optimal and long respectively). Subsequently, among the three groups of patients, the data were analyzed by Kruskal Wallis H-test with multiple comparison procedures using the Scheffé-test in order to compare differences in daytime activity items at seven days after discharge from the hospital. Total daytime nap duration (p p p p < 0.05). However, the duration of night-time sleep and daytime activity did not significantly differ. If actual night-time sleep duration is improved from 360 to 480 minutes, daytime nap could potentially be decreased. Determining objective sleep conditions for patients and treating sleep disorders may improve overall patient health, facilitating appropriate sleep and wake rhythms.

Sleep conditions and quality of life among patients with ischemic heart disease after elective percutaneous coronary intervention

In Japan, percutaneous coronary intervention (PCI) is a major therapeutic intervention for ischemic heart disease (IHD). Previous studies suggested that an association of the risk of IHD caused by sleep duration was related to factors closely associated with daily activities. However, in Japan, there is no study about this relationship objectively measured using the actigraphy in patients with IHD. Moreover, there is little reported data about sleep condition and early outcomes of patient’s Health-Related Quality of Life (QOL) after PCI. This study determines the correlations between sleep conditions and QOL (measured by SF36 version 2) of 25 patients with IHD who underwent elective PCI. Data were collected seven days after PCI using night-sleep condition. Using Spearman’s rank test, the results revealed positive correlation between vitality score and longest sleep duration (ρ = 0.43, p = 0.031): social functioning (SF) score and duration of night-time sleep (ρ = 0.42, p = 0.037);total sleep duration (ρ = 0.45, p = 0.026), and longest sleep duration (ρ = 0.44, p = 0.024);mental health score and longest sleep duration (ρ = 0.54, p = 0.006). However, negative correlation was found between physical functioning score and arousal during sleep (ρ = -0.44, p = 0.027). Sleep condition was significantly correlated with QOL. In particular, SF score was positively related to night-time sleep. This seems to indicate that SF score might be related to night-time sleep condition. Moreover, the longest sleep durations were correlated with the mental component summary. The results of the study suggest that not only the length of whole sleep durations leads to better QOL, but also the increase the amount of uninterrupted sleep.

Protective Effect of Curcumin on Anxiety, Learning Behavior, Neuromuscular Activities, Brain Neurotransmitters and Oxidative Stress Enzymes in Cadmium Intoxicated Mice

Cadmium (Cd) exposure can induce acute lethal health-related threats to humans since it has an exceptional ability to accumulate in living organisms and cause toxicological effects. Curcumin (Cur) on the other hand has a wide variety of biological activities and several animal studies have suggested for a potential therapeutic or preventive effects against several ailments and infections. To study the effect of Cur on the toxicity of Cd, sixty Swiss-Webster strain male mice were divided into 6 groups of ten each at random. Group-1 served as the na?ve control and received no treatment. Group-2, 3 and 4 were the experimental controls and were administered once a day with a single oral dose of 50% dimethyl sulphoxide (DMSO), Cur (300 mg/kg) or Cd (100 mg/kg) respectively, for 2 weeks. Group-5 and 6 received Cur and Cd in combination once a day orally for 2 weeks except that Cur in a dose of 150 and 300 mg/kg to group 5 and 6 respectively, was administered one hour before Cd (100 mg/kg) administration to both groups. After treatment period, the animals were subjected to behavioral tests and thereafter, the animals were sacrificed for the estimation of neurotransmitters like serotonin (5-HT), dopamine (DA) and it’s metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) as well as oxidative stress enzymes like lipid peroxides in the form of thiobarbituric acid–reactive substances (TBARS) and total glutathione (GSH) in the forebrain tissue. Cd reduced significantly the body weight gain, the locomotor activity, anxiety behavior in the plus maze and the learning capability (cognitive effect) in the shuttle-box test. Biochemical analysis further revealed that Cd exposure significantly altered the brain neurotransmitters and the oxidative stress enzymes. However, administration of Cur along with Cd had an ameliorating effect on all the behavioral and biochemical parameters studied herein and reduced the toxicity of Cd significantly and dose-dependently. Thus, Cur may be beneficial for anxiety, neuromuscular, and cognitive problems and protect from Cd intoxication.

The relationship between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus:The mediating effect of self‑efficacy

Objective:The aim of this study is to investigate the mediating effect of self‑efficacy between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 347 empty‑nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self‑designed General Information Questionnaire,the Self‑efficacy for diabetes,the Diabetes Distress Scale,and the summary of diabetes self‑care activities.Diabetes‑related distress and diabetes self‑management were tested for correlation analysis with self‑efficacy.Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self‑efficacy as an intervention variable between diabetes distress and self‑management.Results:About 68.59%of patients suffered from diabetes‑related distress.The results of bivariate correlations revealed that self‑efficacy was negatively correlated with diabetes‑related distress(r=–0.627,P<0.01)and positively correlated with self‑management(r=0.356,P<0.01).The relationship effects of diabetes distress on self‑management were fully mediated by self‑efficacy.Conclusions:Diabetes‑related distress prevails in empty‑nest elderly patients with T2DM.Self‑efficacy plays a mediate role between diabetes‑related distress and self‑management.Psychological intervention is contributed to reducing diabetes‑related distress.

Impact of the emigration of nurses on health care delivery system in selected hospitals,Benin‑City,Edo State,Nigeria

Background:Globally,there is a high demand for nurses,resulting in migration from low‑to high‑income countries.The emigration of nurses is the act of leaving one's own country to settle permanently in another country,leading to a shortage in the number of nurses in their home countries.Consequently,this study aims to assess the impact of the emigration of nurses on the health‑care delivery system in Nigeria.Materials and Methods:A descriptive cross‑sectional survey was conducted with a stratified sampling technique to select 270 nurses from three selected hospitals in Benin‑city Edo state.A self‑structured questionnaire with open and Likert scale questions were used as an instrument to assess the Impact of the Emigration of nurses on the Health Care Delivery System.Data collected were analyzed using tables,percentages,means,standard deviation and t‑test.Results:The result showed a mean score of 1.59±0.92 impacts of the emigration of nurses on health‑care delivery system and identified how to reduce it.The study also showed that there is no significant difference between gender and reason for emigration among nurses(t=3.84,P≤0.001).Conclusion:The emigration of nurses is severely affecting the health care delivery system in the country.Recently,the Nursing and Midwifery Council of Nigeria gave the directive for training schools to increase their training capacity and number of students’intake to cushion the effect,and this study shows that this palliative can only be a short time measure,and however will encourage more nurses traveling abroad on the long run.Therefore,the hospital managers and government should provide a conducive working environment,better remuneration,attractive retirement benefit,and other incentives as a push in factor for nurses to stay back in their home countries.

Impact of auditory stimulation nursing protocol on auditory response in cerebrovascular stroke patients

Objectives:The objective of the study was to explore the impact of auditory stimulation protocol on auditory response in cerebrovascular stroke(CVS)patients.Materials and Methods:A pre-posttest nonequivalent control group quasi-experimental study was conducted at Al Mainal Hospital at Al Kars Einy Hospital,Cairo University,among 60 CVS patients,and the sample was randomly assigned through a coin to allocate subjects to study or control group(30 for each group).Auditory stimulation techniques were applied three times per week for the study group for two consecutive weeks.Patients in the control group received only routine hospital care during the study period.The Glasgow Coma Scale(GCS)score for assessing the neurological function and level of arousal and the auditory subscale score of Western Neuro Sensory Stimulation Profile(WNSSP)for assessing auditory response were recorded and compared between the two groups before and after the intervention.Results:There were statistically significant differences between the study group and the control group regarding third reading of GCS score(11.5±0.3 vs.10.6±0.9,t=4.676,P=0.000).The scores of all auditory subscales of WNSSP in the study groups increased after implementing the auditory stimulation protocol(P<0.05).Conclusion:Utilizing the auditory stimulation protocol by nurse proves to be an effective method for enhancing hearing responses in individuals with CVS.

Uptake of in-vitro fertilization among couples attending fertility clinic in a tertiary health institution

Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City,Nigeria.Methods:This study adopted a cross-sectional descriptive design.A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic.Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science(SPSS)version 21.Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square,univariate statistics and multivariate logistic regression analysis.Results:Among 250 couples,154(61.6%)were willing to adopt IVF.The multivariate logistic regression analysis showed that catholic religion[odds ratio(OR)0.21,95%confident interval(CI)0.54-0.73],family income(OR 1.50,95%CI 1.10-2.00)and age(OR 1.04,95%CI 1.01-1.10)were the major factors that determined the uptake of IVF,with P-value of<0.001,0.018 and 0.031,respectively.Conclusions:The uptake of IVF could be sustained or improved on,if the government should improve on the cost of living for families,and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.