A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.
Background Moral distress is a poorly defined and frequently misunderstood phenomenon, and little is known about its triggering factors during ICU end-of-life decisions for nurses in Iran. This study aimed to explore the experiences of nurses’ moral distress in the long-term care of older adults via a phenomenological study. Methods A qualitative, phenomenological study was conducted with 9 participants using in-depth semi-structured interviews. The purpose was to gain insight into the lived experiences and perceptions of moral distress among ICU nurses in hospitals affiliated with Tehran University of Medical Sciences during their long-term care of older adults. Results Five major themes are identified from the interviews: advocating, defense mechanisms, burden of care, relationships, and organizational issues. In addition, several subthemes emerged including respectful end of life care, symptom management, coping, spirituality, futile care, emotional work, powerlessness, relationships between patients and families, relationships with healthcare teams, relationships with institutions, inadequate staffing, inadequate training, preparedness, education/mentoring, workload, and support. Conclusions This qualitative study contributes to the limited knowledge and understanding of the challenges nurses face in the ICU. It also offers possible implications for implementing supportive interventions.
Lupus is a chronic autoimmune disease that can become a bio-psycho-socio-economic-culture-spiritual burden for individuals because its complex treatment and management. Self-acceptance and adherence to medication are the keys in lupus management. Purpose of this study was to determine the relationship between self-acceptance level of lupus patients and their medication adherence level. The study was designed using a correlational study with a cross sectional approach. About 92 lupus patient respondents at Kupu Parahita Indonesia Foundation who went to the Saiful Anwar Hospital Malang were selected using purposive sampling according to inclusion and exclusion criteria. Respondents were asked to fill out a modified Acceptance of Illness questionnaire to measure patient self-acceptance level and the Morisky Medication Adherence Scale 8 (MMAS-8) to assess drug adherence level. From the 92 respondents, it was found that 37% had a high level of self-acceptance, 52.2% were moderate, and 10.8% were low. Adherence medication level in 92 respondents showed 51.1% high, 38.1% moderate, and 10.8% low. Spearman test results showed a significant relationship between self-acceptance level and medication adherence level (p=0.001, r=0.355). This value indicates the strength of the weak relationship and the direction of the positive correlation between self-acceptance and medication adherence. Conclusion, the higher of self-acceptance level of lupus patients, the higher medication adherence level.
Terapi pemberian oksigen (O2) melalui nasal kanul menjadi salah satu terapi yang seringkali diberikan pada pasien di tatanan klinis. Humidifier merupakan alat yang membantu melembabkan oksigen yang diberikan dengan harapan agar oksigen murni yang kering tidak mengiritasi saluran pernafasan pasien. Permasalahan timbul ketika penggunaan alat, terutama cairan humidifier tidak digunakan dengan benar dan menimbulkan resiko kontaminasi. Kontaminasi tersebut malah berisiko menimbulkan infeksi nosocomial yang tentunya dapat memperberat masalah pasien. Terapi oksigen non-humdifikasi dapat menjadi pilihan. Perawat harus memahami dengan baik penggunaan terapi oksigen dengan humidifier maupun tanpa humidifier. Kegiatan ini terdiri dari 3 tahap kegiatan: persiapan, pelaksanaan, dan evaluasi yang bertujuan untuk meningkatkan pengetahuan perawat tentang terapi O2 non-humidifier. Hasil evaluasi kegiatan ini pengetahuan perawat yang meningkat adalah sebesar 100% dari sebelum pelatihan yaitu sebesar 75%. Seluruh peserta aktif berpartisipasi dalam diskusi. Kesimpulan dari kegiatan bahwa edukasi dapat meningkatkan pengetahuan perawat tentang pemberian terapi oksigen non humidifikasi. Terapi oksigen non-humidifier juga dapat di pertimbangkan untuk digunakan di ruang perawatan khusus yang mempunyai tingkat kelembaban dan kebersihan ruangan yang baik.
Context: Medication and low salt diet adherence play as an essential factor in blood pressure target achievement. Community health worker empowerment was reported to be a highly effective social intervention to medication and low salt diet adherence. Aims: This study aimed to investigate the effect of structured health education regarding hypertension on community health workers on medication and low salt diet adherence among hypertensive patients in Malang. Subjects and Methods: A quasi-experimental study was conducted in health workers and their hypertensive patients who join in the Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Malang. Medication adherence was measured by the medication adherence questionnaire and low salt diet adherence was measured by dietary salt restriction questionnaire. The data were analyzed by Chi-square analysis for categorical data and independent t -test for numerical data. Results: This study showed that hypertensive patients in the intervention group had better knowledge regarding hypertension compared to those of the control group ( P < 0.05). The patients' satisfaction in intervention group improved significantly after health education ( P < 0.01). The proportion of patients with good medication adherence improved significantly ( P < 0.01) from 20% to 70% after health education in intervention group. Moreover, the proportion of patients with good low salt diet compliance improved significantly ( P < 0.01) from 39% to 85%. Conversely, the proportion of good medication and low salt diet adherence in control group relatively similar between pre- and post-test. Conclusions: This study showed that health education on community health workers improved hypertensive patients' medication and low salt diet adherence.
The long-term treatment that a hypertensive patient has to undergo has resulted in the patient becoming non-adherent. Patients accidentally not taking medication is one of the causes of non-adherence. A method for preventing non-compliance due to forgetting to take medication is important. The AIMOHit application which means "Let's Remember to Take Hypertension Medication" is designed to support hypertensive patients to be compliant in taking medication. This study aims to identify the effect of AIMOHit application on adherence to taking medication for hypertensive patients in the Janti Health Center, Malang City. A total of 52 hypertensive patients were willing to be the sample in this study. The instrument used was the AIMOHit application on the Android smartphone for the treatment group and the checklist for the control group. It is known that the adherence statistical test showed that the average adherence to taking medication in the treatment group was higher (32.17) than the control group (20.83). Meanwhile, the Mann Whitney test results obtained p value = 0.000 (<0.05). The conclusion is that there is a significant effect of AIMOHit application on compliance with taking medication for hypertension sufferers in the Janti Health Center, Malang City.
Introduction: Type 2 Diabetes Mellitus (T2DM) is associated with changes that occur in the peripheral circulation that affect foot functions. Therefore, there is a need for a risk prediction test on foot abnormalities using the leg pain response parameters in T2DM patients with ankle-brachial index (ABI) and peripheral sensory changes as a preventive effort to manage foot care. Design and Methods: This study employed a cross-sectional design in which 63 T2DM patients in a Public Health Center (PHC) in Malang were investigated. The instruments used include visual analog scale (VAS), monofilament, and foot doppler. Results: The Pearson correlation test showed no relationship between the responses to leg pain and the ABI of the right and left feet (p-values = 0.217 and 0.692), but there was a significant relationship between the left foot ABI and sensory status (p-value 0.002; left foot r = 0.383). Meanwhile, the Pearson's correlation and linear regression test also showed a relationship between the right foot ABI and sensory status (p-value = 0.007; r = 0.338). Furthermore, a multiple linear regression test showed a relationship between the leg pain response and sensory perception of the right and left feet (p-value = 0.035; r = 0.325). Conclusions: The relationship between the sensory status of the right and left feet and the response to leg pain in T2DM patients were moderate with a negative direction. It, therefore, implies that a decrease in the sensory responses increased the leg pain. Meanwhile, the moderate relationship and positive direction between the ABI and sensory status of the feet of T2DM patients indicates that a higher ABI score led to an increase in the sensory status of the foot.
Introduction: The COVID-19 pandemic has caused a major shift in the healthcare delivery system. With the limited personal protection equipment and a nursing service shortage caused ineffective nursing care delivered to COVID-19 patients. Wearing full personal protective equipment (PPE) hinders nurse-patients communication and inhibiting the achievement of treatment goals. This study aims to examine the effect of a ‘COVID Nurse Assistant’ (CNA) application on patient satisfaction in COVID-19 isolation rooms. Design and Methods: This was a comparative study with an experimental and control group design. The participants were patients confirmed positive with COVID-19 receiving care in an isolation room for at least three days and were fully conscious. The intervention used was accessing health information related to COVID-19 through a mobile-friendly application namely-‘COVID Nurse Assistant’. The instrument used was the Patient Satisfaction Questionnaire (PSQ-18) translated into Bahasa Indonesia. In addition, an independent t-Test was used to perform statistical analysis. Results and Discussions: A total 158 respondents completed the online survey among of 219 eligible patients (72% response rate). The score in the general and financial satisfaction sub-scales reported by patients in the experimental group were significantly different from the control with p-values of 0.032 and 0.018 respectively. However, other subscales were not significantly different between the two groups. Conclusions: The implementation of the CNA online application has noteworthy implications on patient satisfaction. However, further studies examining similar system in different clinical areas would provide better information for the optimal use of technology in patient education.
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