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BackgroundOne of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal.MethodsA descriptive cross-sectional study included 82 participants from the Spinal Injury Rehabilitation Center and communities in Nepal. Participants completed the Demographic and Injury-related Questionnaire, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, Moorong Self-efficacy Scale, Intrinsic Spirituality Scale, and Patient Health Questionnaire-9. Pearson’s correlation and point biserial correlation analyses were performed to examine associations between resilience and independent variables. A hierarchical regression analysis was used to identify the influence of certain factors.ResultsFindings indicated significant associations between resilience and social support (r = 0.42, p < 0.001), self-efficacy (r = 0.53, p < 0.001), depressive mood (r = − 0.50, p < 0.001) and demographic variables which included sex (r = 0.47, p < 0.001), employment (r = 0.27, p = 0.016), and current living location (r = 0.24, p = 0.029). There was a non-significant association between resilience and spirituality (r = − 0.12, p > 0.05). In hierarchical regression analysis, an overall regression model explained 46% of the variance in resilience. Self-efficacy (β = 0.28, p = 0.007) and depressive mood (β = − 0.24, p = 0.016) significantly determined resilience after controlling the effect of demographic variables. Among the demographic factors, being male significantly explained the variance in resilience (β = 0.31, p = 0.001).ConclusionsMultiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.

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Background: Pressure injury (PI) remains a critical health issue worldwide. The global incidence of hospital-acquired PI is 8.4%, and among intensive-care unit (ICU) patients, it is even higher, ranging from 6.60% to 36.80%. It is important to investigate ICU nurses' PI prevention knowledge, attitudes, and practices (KAP). Aim: The aim of this study was to describe the level of Chinese ICU nurses' knowledge, attitudes, and self-reported practices of PI prevention. Materials and Methods: From March 31 to April 30, 2019, we recruited a total of 510 ICU nurses into the current study using convenience sampling. The Modified Pressure Ulcer Knowledge Assessment Tool version 2.0, Attitudes toward Pressure Ulcer Prevention instrument, and Questionnaire to evaluate nurses' Adherence to Recommendations for Preventing Pressure Ulcers were used for data collection. We used one-way analysis of variance, Student's t-test, and the Mann-Whitney U-test to assess differences in knowledge, attitudes, and self-reported practices of PI prevention among ICU nurses, whom we categorized by their demographic characteristics. Results: Mean scores of participants' knowledge, attitude, and their self-report practice were 65. 82 ± 9.29, 76.65 ± 8.62, and 83.35 ± 13.55, respectively. Participants with bachelor's degrees or higher, who worked in tertiary hospitals, and who had received training on PI prevention over the last year had higher scored on PI prevention knowledge (all P < 0.05). Participants who had received training on PI prevention over the last year scored higher on attitude than those who had not received such training over the last year (P = 0.001). Conclusion: ICU nurses surveyed in this study did not demonstrate an acceptable level of knowledge about PI prevention, while their attitudes and self-reported practices were acceptable. Continuing education or in-service training should be provided to enhance ICU nurses' knowledge of PI prevention.

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Diabetic Foot Care Behaviors (DFCB) is the fundamental component of diabetic foot complications prevention. Many diabetic patients, however, did not perform foot care properly. Furthermore, SelfManagement (SM) support program was noted as effective approach improving diabetes patients' behaviors. Unfortunately, there have been no studies published applied this approach to improve DFCB in Indonesia. This study aimed to determine the effectiveness of a self-management support program in improving DFCB in patients with diabetes mellitus in West Java, Indonesia. Quasi-experimental study was conducted with seventy subjects who randomly assigned either to an experimental (n = 35) or a control group (n = 35). The subjects in the experimental group received a five-week diabetic foot care SM support program. The subjects in the control group received standard care. Their DFCB was evaluated in the fifth week of intervention using a DFCB Questionnaire. The results showed that the DFCB in the experimental group was significantly higher (M = 67.43, SD = 5.83) than that in the control group (M = 52.60, SD = 8.6) (p<0.001). The result indicates that a five-week SM program effectively enhanced DFCB. Thus, nurses are recommended to apply this program in improving DFCB in order to prevent diabetic foot ulcers or other foot complications.

More than half of Nepalese who sustained SCI from the 2015 earthquake in Nepal had not achieved a high level of resilience 2 years later. Gender was a significant determinant of resilience. The results highlighted the importance of providing appropriate intervention and allocating continuing support to the Nepalese people with SCI. A further longitudinal study is recommended to determine predictive factors of the dynamic nature of resilience.

She completed her bachelor degree from Mahidol University, Thailand. She pursued her Master degree and doctoral degree from Case Western Reserve University, the United States. She is an expert in the area of promoting health behaviors in communities. She was recipient of Excellent Researcher award in the year 2009. She is also interested in conducting research to improve quality of teaching and learning. She is now the head of Division of Community Nurse Practitioner, Faculty of Nursing,