Effect of Training Nurses in ICU in Immediate Care Post Cardiac Surgery

The specialty of cardiovascular surgical nursing has advanced patient care significantly both before and after surgery, and it is now a well-established field. The primary goal of cardiovascular surgical nursing is to optimize the patient's recovery and prevent complications. Immediate nursing care for post-operative cardiac patients in a state of controlled shock due to fluid shift and varying vascular tone. Aim of the Study: Assessment of nurse’s knowledge and performance after the training program of nursing care immediately after a patient arrives from cardiac surgery. Methods: This pre and post-intervention study was conducted at cardiac centers in Sudan Alshaab and Ahmed Gasim Cardiac Center. The aim of the study was to evaluate the impact on nurses’ performance after training program post open-heart surgery. In the initial phase of the study, all 98 nurses working in the intensive care units at Alshaab and Ahmed Gasim cardiac centers were designated as the study group and evaluated before the intervention. Subsequently, the same group was reassessed after the intervention (phase 2), allowing for a comparison of the pre- and post-intervention results. The assessment involved the use of a specifically designed questionnaire and an observation checklist developed in accordance with the standards recommended by the American Nurses Association (phase 3). Result: Descriptive analysis was performed using the Chi-square test, the difference in the performance between the study group before intervention and after the intervention was assessed by the mean of chi-square significantly was taken as p < 0.05.

沙特阿拉伯护生临床环境压力源和应对行为的调查研究

目的本研究旨在调查沙特阿拉伯女性护生在临床实践中的压力水平、压力源和应对策略现状。方法采用横断面调查法。于2022年1-5月,采用便利抽样法选取沙特阿拉伯1所大学中分别在利雅得、吉达和阿拉尔莎参加临床课程的护理学院女生为研究对象,应用一般资料调查表、感知压力量表(the Percei-ved Stress Scale,PSS)和应对行为量表(the Coping Behavior Inventory,CBI)进行资料收集。结果共有322名护生参与此研究,PSS得分为3~99(54.77±0.95)。学业和工作量是护生最常见的压力源类型(2.61±0.94),其次是来自环境的压力(1.18±0.47)。同时,保持乐观为学生最常采用的应对策略(2.38±0.95),其次是转移(2.36±0.71)和问题解决策略(2.35±1.01)。回避应对策略与所有压力源类型呈正相关(P<0.01)。问题解决策略与来自同学和日常生活的压力呈负相关(r=-0.126,P<0.05)。转移与来自学业和工作量的压力(r=0.121,P<0.05)以及来自教师和护理人员的压力(r=0.156,P<0.01)呈正相关。保持乐观策略与护理患者的压力(r=-0.149,P<0.01)以及缺乏专业知识和技能的压力(r=-0.245,P<0.01)呈负相关。结论这些研究结果对于护理教育者确定护理专业女生的主要压力源和使用的应对策略具有重要意义。应采取有效措施减轻学生实习期间的压力水平及改善学生的应对策略。

Effect of Health Education Program on Self-Efficacy and Functional Capacity of Patients with Coronary Artery Bypass Surgery in Khartoum State-Sudan, 2015-2019

Coronary heart disease is among the most prevalent and costly of all global health problems. Coronary artery bypass grafting (CABG) has been increasingly used since the 1960s. Coronary heart disease is a leading cause of death worldwide, including Sudan. Self-efficacy and functional capacity is a critical factor for quality of life in patients who has undergone CABG as well as for their caregivers from their families. Aim of the Study: To explore the effects of an educational program on self-efficacy and functional capacity of patients after CABG. 1) There will be no significant difference between the intervention group and control group concerning knowledge regarding Self-efficacy and functional capacity post CABG surgery. 2) The application of our educational program for the patients will enhance the patients with CABG surgery and improve knowledge about Self-efficacy and functional capacity post CABG surgery. 3) There are some socio demographic factors that affect the response to the educational program. Methods: This was a quasi-experimental, interventional and hospital-based study, including pre-test, a post-test and follow-up test, with a control group, conducted during the period from September 2014 to June 2019. Patients were recruited consecutively to the cases and control group using convenience sampling. The sample consisted of 76 patients;41 as cases and 35 as control group. The sample included those who had undergone CABG in Khartoum State. Relevant data were collected using a checklist to monitor the effect of a health education program on self-efficacy and functional capacity of the patients. Result: The results showed marked improvement in patients’ self-efficacy and functional capacity between pretest and posttest for the study group;p-value = (0.001) in the health status of cases in comparison to the control group. The indices were observed to be higher for patients who received a nursing educational program throughout the study period;p-value = (0.002).

The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design

Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.

Overcoming Barriers to Uptake of Voluntary Medical Male Circumcision in a Traditionally Circumcising Community in Machinga District, Malawi

Introduction: Voluntary medical male circumcision (VMMC) reduces chances of contracting HIV during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. However, its uptake among traditionally circumcising communities, where male circumcision carries a cultural significance, has not been studied. Previous research has focused on barriers to uptake of VMMC in non-circumcising communities. This study was conducted to determine socio-cultural barriers to VMMC uptake in order to identify culture-sensitive and evidence-based interventions to increase its uptake. Methodology: This exploratory mixed methods cross-sectional study generated quantitative data from 262 randomly sampled sexually active men;and qualitative data through four focus-group discussions with 58 purposely selected male participants and 10 key informants. Results: The study established that only 6.3% (n = 15) of those circumcised (90.8%, n = 238) were circumcised in clinical setting. Limited access to VMMC services, cost, pain, being attended to by female providers and cultural influences were the major hindrances to uptake of VMMC. Conclusion: Although there is a paradigm shift of preference from traditional male circumcision to VMMC in this community, its uptake is low. The study recommends that besides introducing mobile VMMC services, the Ministry of Health should collaborate with traditional circumcisers and local leaders to provide gender-and-culture-sensitive safer medical male circumcision services.

An Audit of Admissions to Intensive Care Unit at Kamuzu Central Hospital in Malawi

Results are presented of a retrospective audit of admissions to the Intensive Care Unit (ICU) of Kamuzu Central Hospital in Lilongwe, Malawi, which is a tertiary referral facility. The audit was conducted for a period of one year spanning from January to December, 2012. The objectives of the audit were to: describe the profile of admissions and treatment outcomes of the admissions and identify main causes of mortality in ICU of the facility. The admission book and patients’ records were reviewed retrospectively guided by a data extraction form which was specifically designed for this study. The extracted data included age, sex, referring unit, diagnosis, treatment outcome and length of stay. The data were analyzed using STATA version 10.0. A total of 253 patients were admitted to the ICU over the one year period of study. About a third of the patients (33.6% n = 85) were admitted due to postoperative surgery. There were 154 deaths representing an overall mortality of 60.9%. Sepsis was the commonest cause of death and accounted for 39.6%, n = 61 of the deaths. Younger age of less than 40 years and increased patients’ length of stay in the unit were significantly and positively associated with mortality (P < 0.05). The high mortality rates among patients admitted to ICU reflects numerous challenges at various levels of critical care service delivery in the country. There is therefore a need to strengthen critical care services to improve treatment outcomes for patients admitted to ICU of the facility.