Prediction Pressure Ulcers in High Care Unit Patients: Evaluating Risk Factors and Predictive Scale Using a Prospective Cross-Sectional Study.

Background The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin scales. However, other risk factors, such as age, gender, consciousness, systemic condition, duration of treatment, and use of restraint, may contribute to the occurrence of ulcer pressure. This study was conducted to analyze the relationship of various risk factors for pressure ulcers and prediction of ulcer pressure, using Norton and Jackson/Cubbin scale, to incident pressure ulcers in HCU patient. Methods This study utilized a prospective cross-sectional study design to analyze various risk factors for ulcer pressure development in a patient admitted to the HCU, including age, gender, blood profile, consciousness, duration of treatment, and use of restraint. The Norton and Jackson/Cubbin scale was employed to predict pressure ulcers. The relationship between the risk factors and the prediction of pressure ulcer incidents was evaluated using multiple logistic binary regression analysis. Result Both the Norton and Jackson/Cubbin scales predicted a lower risk of pressure ulcer development (60.98 and 99.02%, respectively). This prediction is consistent with the low incidence of pressure injuries found, which is only 4.39%. Furthermore, the relationship between the identified risk factor (gender, duration of treatment in HCU and use of restraint) and the prediction and incident of pressure ulcer was not significant ( p > 0.05). Thus, it is suggested that these risk factors may not strong predictors of pressure ulcer development. Conclusion This study's result indicated no significant relationship exists between possible identified risk factors and the development of pressure ulcers in HCU patients. However, the Norton and Jackson/Cubbin scales were reliable predictors of pressure ulcer occurrence, with both scales predicting a lower risk of pressure ulcer development.

Management of non-cirrhotic variceal bleeding in pregnant women with Budd-Chiari syndrome in the early second trimester: A case report.

Budd-Chiari syndrome is one of the post-hepatic causes of portal hypertension and a potential obstruction causes liver fibrosis. In pregnancy, obstruction of hepatic veins could occur due to stenosis or thrombosis. Variceal bleeding is the most fatal complication in pregnancy with co-existing Budd-Chiari syndrome, with 29.4% incidence of abortion and 33.3% perinatal mortality. The aim of this case report was to present the management of non-cirrhotic variceal bleeding in pregnant women with Budd-Chiari syndrome in the early second trimester. We report a pregnant female at 13-14 weeks gestation presented to the hospital with profuse hematemesis. Doppler ultrasonography (USG) was utilized to confirm the diagnosis of Budd-Chiari syndrome-hepatic vein occlusion type in pregnancy. Abdominal USG revealed hepatomegaly with hepatic veins dilation, while endoscopy showed grade IV esophageal varices and grade IV gastric varices. Laboratory results indicated disseminated intravascular coagulation due to hemorrhage. The patient was given strict fluid resuscitation and three packed red cells transfusion to stabilize the hemodynamic. Bleeding was successfully managed by intravenous octreotide, tranexamic acid, and vitamin K. The case highlights that the management of non-cirrhotic variceal bleeding in pregnancy with Budd-Chiari syndrome requires a multidisciplinary approach and regular fetal monitoring to ensure optimal outcomes.

The Needs of Nurses to Improve Nursing Care for HIV-Positive MSM in Indonesia: A Qualitative Descriptive Study.

Purpose: The existence of HIV-positive men who have sex with men (HIV-positive MSM) in Indonesia is controversial because it goes against current norms. As a result, they are unable to confide in themselves about their identities. Therefore, it is often difficult for nurses to identify those who need treatment. This study aimed to explore the needs of nurses to improve nursing care for HIV-positive MSM. Materials and Methods: The qualitative study with a purposive sample of 15 nurses participated in semi-structured and in-depth interviews. The data is analyzed by thematic analysis. Results: Three key themes emerged:(1) effective therapeutic communication techniques for HIV-positive MSM, (2) increasing the skills and knowledge of nurses; (3) continuity of care. Conclusion: The need to improve the knowledge and skills of nurses in caring for HIV-positive MSM will impact the quality of nursing care and lead to better patient's center care. Furthermore, it will increase satisfaction with the nursing care provided.

The Effectiveness of Digital-Based Psychotherapy in Overcoming Psychological Problems in College Students During the COVID-19 Pandemic: A Scoping Review.

Purpose: This review aims to determine the effectiveness of the application of digital-based psychotherapy in overcoming the psychological problems of college students during the COVID-19 pandemic. Methods: Several databases consisting of EBSCO-Host CINAHL, PubMed, Scopus, Sage Journal, and Taylor and Francis were used in the search process and resulted in experimental studies focusing on the effectiveness of the application of digital-based psychotherapy during the COVID-19 pandemic timeline (2019-2022). Descriptive and exploratory analyses were performed based on the data set from the study. Results: A total of 12 articles were included in the review. The digital psychotherapy interventions found are diverse including websites, smartphone applications, and video conferencing with the types of therapies provided in the form of, Cognitive Therapy, Cognitive-Behavioral Therapy, Psychodynamic Therapy, and Mindfulness Therapy. Each intervention has a diverse duration and frequency adjusting to the type of therapy given. Digital psychotherapeutic interventions are effective in reducing mental health problems among college students during the COVID-19 pandemic. Conclusions: The use of digital psychotherapy can be used as a prevention and support service for students who experience psychological problems during the COVID-19 pandemic. The combination of the use of digital media with video conferencing can be considered to increase the effectiveness of this service. Nurses need to understand how the procedure for implementing digital-based psychotherapy is to improve the quality of mental care services as an effort to prevent and support students. More research is needed to find out the effectiveness of the use of digital psychotherapy services and how they impact the psychological well-being of students holistically.

A Scoping Review of the Online Interventions by Nurses for Reducing Negative Impact of Bullying on Students.

The incidents of bullying on students have increased every year. The negative impacts of bullying are physical problems, psychological problems such as depression and anxiety, and even risk of suicide. Interventions by online to reduce the negative impact of bullying are more effective and efficient. The aim of this study is to explore method of online-based nursing intervention on students for reducing the negative impact of bullying. This study used a scoping review method. The literature from three databases were PubMed, CINAHL, and Scopus. PRISMA Extension for Scoping Reviews was used for search strategy and we used keywords were "nursing care OR nursing intervention" AND "bullying OR victimization" AND "online OR digital" AND "student". The inclusion criteria for articles were primary research, the design of articles are randomized control trial or quasi-experimental, samples were students, and the setting time of publication is last 10 years (2013-2022). We found 686 articles based on initial research, after elimination based on inclusion and exclusion criteria, and found 10 articles discussing about online-based interventions by nurses on students for reducing the negative effects of bullying. The range of respondents in this study is 31-2771 respondents. The method used for the online-based nursing intervention were improving students' skills, increasing social skills, and counseling. The types of media used are videos, audio, modules, and online discussions. Online interventions were effective and efficient so that they are easily accessible to participants, however, it causes difficulties for participants to access interventions due to internet network disruptions. The potential of online-based nursing interventions is effective to reduce the negative impact of bullying with give full attention in physical, psychological, spiritual, and cultural aspect.

Nursing Care on HIV/AIDS-Positive Men Who Have Sex with Men: A Qualitative Descriptive Study of Nurse's Perspective in Indonesia.

HIV/AIDS-positive men who have had sex with men (MSM) account for roughly one-third of new infections in the region, with numerous nations facing a high and rising prevalence. They often face stigmatization and discrimination from society, including nurses. This study aims to explore nurses' perspectives on caring for HIV/AIDS-infected MSM. A descriptive qualitative design was utilized. Fifteen nurses who cared for HIV/AIDS-positive MSM in the two hospitals in Jakarta, Indonesia, were recruited with purposive sampling techniques. A semi-structured and in-depth interview was conducted. Data were analyzed using thematic analysis. We emerged three superordinate and nine subordinate themes: (1) negative nurse perceptions in the early phase of treatment, (2) nurse attitudes contrasting with negative perceptions, and (3) nurses with knowledge of HIV/AIDS. The negative perceptions appeared only at the beginning of the treatment phase, and thereafter, they were followed by a positive attitude. Nurses appeared to develop a better understanding after interacting with their patients and receiving training on HIV/AIDS. Therefore, intensive training is expected to not only increase their knowledge but to encourage a positive attitude.

Triple-P e-Parenting to Improve Awareness of Psychiatric Nurses on Preventing Cyberbullying in Adolescents.

The impact of cyberbullying includes mental health problems and an increased risk of suicide. Psychiatric nurses play an important role in reducing the impact of cyberbullying on students. Nurses, educators, and counselors also play a role to prevent cyberbullying by improving awareness. The purpose of this study is to explore the awareness and involvement of mental nurses and their motivation and confidence in preventing cyberbullying. The research method used in this study was a quasi-experimental pre-post tests study. The sample in this study included 192 respondents. Data analysis used a t-test (pair t-test). This study shows that seminars about cyberbullying and Triple-P e-Parenting are effective in increasing nurses' awareness regarding the incidence of cyberbullying in adolescents (p < 0.001). The aspects that influence the increase in awareness of mental nurses are attitude (p < 0.001) and parenting (p < 0.001). Awareness of nurses as parents related to cyberbullying is important to prevent cyberbullying in adolescents. Seminars about cyberbullying, the role of parents, and how to prevent cyberbullying are effective in preventing cyberbullying in adolescents by paying attention to the experiences of parents who have children affected by cyberbullying.

Massive hemobilia caused by rupture of gastroduodenal artery pseudoaneurysm, a delayed complication of laparoscopic cholecystectomy: a case report.

BACKGROUND: Hemobilia is a rare cause of upper gastrointestinal bleeding that originates from the biliary tract. It is infrequently considered in diagnosis, especially in the absence of abdominal trauma or history of hepatopancreatobiliary procedure, such as cholecystectomy, which can cause arterial pseudoaneurysm. Prompt diagnosis is crucial because its management strategy is distinct from other types of upper gastrointestinal bleeding. Here, we present a case of massive hemobilia caused by the rupture of a gastroduodenal artery pseudoaneurysm in a patient with a history of laparoscopic cholecystectomy 3 years prior to presentation. CASE PRESENTATION: A 44-year-old Indonesian female presented to the emergency department with complaint of hematemesis and melena accompanied by abdominal pain and icterus. History of an abdominal trauma was denied. However, she reported having undergone a laparoscopic cholecystectomy 3 years prior to presentation. On physical examination, we found anemic conjunctiva and icteric sclera. Nonvariceal bleeding was suspected, but esophagogastroduodenoscopy showed a blood clot at the ampulla of Vater. Angiography showed contrast extravasation from a gastroduodenal artery pseudoaneurysm. The patient underwent pseudoaneurysm ligation and excision surgery to stop the bleeding. After surgery, the patient's vital signs were stable, and there was no sign of rebleeding. CONCLUSION: Gastroduodenal artery pseudoaneurysm is a rare complication of laparoscopic cholecystectomy. The prolonged time interval, as compared with other postcholecystectomy hemobilia cases, resulted in hemobilia not being considered as an etiology of the gastrointestinal bleeding at presentation. Hemobilia should be considered as a possible etiology of gastrointestinal bleeding in patients with history of cholecystectomy, regardless of the time interval between the invasive procedure and onset of bleeding.