Effectiveness of Digital Learning in Community Mental Health Care Among Nurses in India.

Background: Digital learning is a cost-effective and time-saving approach in higher education. The present study aimed to check the impact of continuing nursing education programs through digital learning by connecting Indian nurses to NIMHANS Digital Academy (NDA). Materials and Methods: One group pre-test and post-test design was used for this study. Overall, 217 nurses registered for the course and 146 nurses were recruited on the basis of eligibility and their Expression of Interest (EoI) through the online registration portal. All the nurses who had access to the internet and enough internet literacy were included in the study. 64 nurses had not submitted the post-test due to various reasons within the stipulated time. Hence, the final sample achieved and calculated for the analysis was n = 82. The data for this study were collected through the retrospective chart review method. Result: The findings of this study reveal that most of the nurses in India had willingness and readiness for digital learning. All the nurses who joined the NDA learning program stated that they would like to improve their knowledge regarding mental health and illness, to identify and manage mentally ill patients efficiently. The results indicated that the training provided through NDA positively impacted the nurses' knowledge and fulfilled their learning needs. Statistical analysis showed a significant difference between knowledge, practice, and confidence score changes for the two-time point period, i.e. before and after the training. Conclusion: It can be concluded that conducting Continuing Nursing Education (CNE) through a digital learning program is an effective teaching-learning method in the nursing curriculum.

Sexual and reproductive health (SRH) of women with mental illness (WMI) - An integrative mixed-method study.

Background: Women with mental illness (WMI) are more likely to experience unreported sexual and reproductive health (SRH) problems. Mixed-method research studies with the strengths of quantitative and qualitative approaches provide deeper insight into SRH issues of WMI. Methods: A sequential explanatory mixed-method design was used to understand better the SRH problems of WMI attending tertiary care psychiatry hospital. In phase 1, a survey was conducted to identify if they have SRH problems. Women who were identified to have SRH problems were part of Phase II. In this phase, in-depth interview was conducted to explore their lived-in experiences. Integration at the method level was adopted by connection through sampling. Using a narrative approach, integration was accomplished at the level of interpretation and reporting. Results: Among the users, 261 (64.6%) female sterilization, 244 (93%) was the most common, and the other methods like coitus interruptus, male condoms, and intrauterine devices were reported less. Of the non-users, 137 (33.9%) WMI 100 (73%) were unaware of the best family planning approach. Most of them, 377 (93.3%), were ignorant about sexually transmitted infection (STI) symptoms. WMI reported 62 (15.3%) unusual foul-smelling vaginal discharge and 58 (14.4%) genital ulcers, with poor treatment-seeking behavior. Sexual dysfunction in desire, arousal, lubrication, orgasm, satisfaction, and pain were also reported. The findings were described in a single report based on the quantitative data followed by themes obtained from qualitative interviews using weaving techniques under the headings of contraceptive use and its awareness, prevalence of STI symptoms and its treatment, and sexual health experiences. Conclusion: Data integration demonstrated that one-fourth of WMI had inadequate awareness of contraceptive use, were ignorant of STI symptoms, and experienced sexual dysfunction.

Sexual and reproductive health issues of women attending psychiatric clinic in India-A qualitative study.

BACKGROUND: Women with mental illness (WMI) experience considerable disparities in sexual and reproductive health (SRH) when compared to the general population. Due to their restricted access to SRH services, they have unmet contraceptive needs, a greater prevalence of sexually transmitted infections (STIs), and sexual dysfunction. The study aimed to explore the SRH issues of WMI in a tertiary care psychiatric outpatient clinic in Bengaluru, India. MATERIALS AND METHOD: A qualitative hermeneutic phenomenological approach was used. A reproductive age group (18-49 years) WMI (n = 32) was selected by purposive sampling technique. The period of data collection was from January 2021 to September 2021. An in-depth face-to-face interview was conducted using a validated interview schedule. Hycner's explicitation process was used to investigate the constituents of a phenomenon. RESULT: The codes revealed potential themes and subthemes. SRH issues faced by WMI were organized under three main themes, namely, (1) factors responsible for sexual dysfunction, (2) symptoms of STI and treatment adherence, and (3) use of contraception and its barrier. CONCLUSIONS: Sexual dysfunction among WMI is contributed by numerous factors. Women were exhibited limited knowledge of STI symptoms and treatment compliance. Such women experience issues with current method of contraception and are unaware of the alternatives. The findings of this study may be helpful for clinical nurses in drawing attention to and increasing knowledge of the reproductive health issues that women with psychiatric disorders face, taking the required precautions, and devising strategies for minimizing harm.

Development of Agile Scrum Perception Tool to Evaluate Students' Opinions on Agile Methodology in Nursing Education.

Background and Aim: Agile methodology (AM) is an innovative, active, team-based learning method that enhances higher-order thinking (metacognitive ability), collaboration, hands-on training, and student engagement in the classroom and clinical environment. Exploring the student's opinions of AM in teaching helps understand how agile can be utilized in higher education to positively improve learning ability, leadership, and teamwork. Hence, the study aimed to develop the agile scrum perception tool (ASPT) to evaluate the opinions on AM among nursing students. Materials and Methods: A cross-sectional design was carried out to develop ASPT in different phases. The tool was initially derived from focus group discussion and literature review. The preliminary draft was revised and modified based on expert review and suggestions by content and construct validity. Reliability was calculated in terms of internal consistency. The developed tool was evaluated using data from 200 4th-year nursing students. Results: A total of 23 items of ASPT have adequate psychometric properties in terms of reliability and validity. Internal consistency was checked by coefficient alpha, which was 0.87. Construct validity was analyzed by factor analysis; all items were loaded in 6 factors, accounting for 54% of the variance in the total ASPT score. Conclusion: ASPT has good validity, reliability, and broader scope in medical and allied education related to project management, clinical teaching, and classroom teaching.

Lived-in experiences of health care professionals affected with COVID-19.

Background and Objective: Healthcare providers (HCPs) were vital during the COVID-19 pandemic. The healthcare providers affected by COVID-19 underwent various life changing events while continuing their profession during the pandemic. This study is aimed to explore the lived-in experiences of HCPs affected by COVID-19 at a tertiary care Mental Health Institute in India. Materials and Methods: The sampling method was purposive. Twenty two HCPs (eight nursing educators, seven nursing officers, five contractual cleaning workers, and two laboratory technicians) participated in the interviews conducted by the researchers to obtain the lived-in experiences of HCPs who have recovered from COVID-19. Researchers used a sociodemographic form and an interview guide to collect the data. Interviews were audio recorded and analyzed by using Atlas-ti-9 software. Results: All the participants were female, and they revealed various physical, psychological, and social issues faced by HCPs while balancing home and workplace. Thematic data analysis resulted in the emergence of two themes and 11 subthemes related to life changing events. Conclusion: The findings concluded that although the healthcare providers had working experience in the field of mental health, they too experienced mild psychological issues like anxiety, depression, and fear of death because of this pandemic situation.

Effectiveness of structured teaching program on parents' knowledge about child physical abuse.

BACKGROUND: The issue of child physical abuse (CPA) is complex and challenging to study. According to World Health Organization fact sheets for 2020, about 3 in 4 children between 2 and 4 years of age regularly face physical maltreatment by parents or caregivers. It may cause a lifelong impact on physical and mental health. OBJECTIVE: To assess the parents' knowledge and to evaluate the effectiveness of the structured teaching program (STP) regarding child physical abuse (CPA) among parents. METHODS AND MATERIALS: The pre-experimental, "One-group Pre-test Post-test design" was adopted for this study. Parents of children who were admitted for treatment in the child psychiatry centre (CPC) of a tertiary care referral center between January 2019 and January 2020 were recruited for this study. Thirty parents were recruited with a convenience sampling technique. The study was conducted through an online platform (Zoom). Pre-test and post-tests were conducted through Google survey form. Data were collected with a self-developed knowledge questionnaire on CAP. An online structured teaching program (STP) was administered for three alternative days after the pre-test assessment. The post-test assessment was conducted at a two-point time, that is immediately after the STP and after the one-week gap. Descriptive and inferential statistics were used to analyze the data. "One-group Pre-test Post-test design" was adopted for this study. Parents of children who were admitted for treatment in the child psychiatry centre (CPC) of a tertiary care referral center between January 2019 and January 2020 were recruited for this study. Thirty parents were recruited with a convenience sampling technique. The study was conducted through an online platform (Zoom). Pre-test and post-tests were conducted through Google survey form. Data were collected with a self-developed knowledge questionnaire on CAP. An online structured teaching program (STP) was administered for three alternative days after the pre-test assessment. The post-test assessment was conducted at a two-point time, that is immediately after the STP and after the one-week gap. Descriptive and inferential statistics were used to analyze the data. RESULTS: The pre-test knowledge assessment means score regarding child physical abuse was found to be 12, with a standard deviation of 1.73. In the post-test one, 17.30 ± 1.39 and in the post-test two, 16 ± 1.55 with P < 0.001. Analysis revealed statistically significant improvement was found in the post-test knowledge regarding child physical abuse among the parents. There was no significant (p < 0.05) relationship found between the socio-demographic variables of the participants and their pre-intervention knowledge scores on child physical abuse. CONCLUSIONS: The study findings reveal that parents have a fair knowledge of CPA and the STP was effective and feasible to administer in improving the subjects' knowledge regarding child physical abuse.

Development and validation of "Knowledge on screening and identification of mental illness (KSIM) questionnaire" among primary care nurses in India.

BACKGROUND: As stated in the World Health Organization's Mental Health Report 2022, 13%, or almost a billion people, had a mental health issue, and 82% of these people resided in low- and middle-income countries with limited access to mental health treatments. Successful integration of mental health services into primary healthcare depends on primary healthcare providers receiving the proper training and information required to provide basic mental health care in the community. Primary care nurses generally lack the confidence and skills to handle mental health issues while being in an excellent position to screen, identify, refer, and follow-up on a person with mental illness (PMI). The study aimed to develop and validate the KSIM questionnaire to assess the knowledge of primary care nurses in screening, identifying, referral, and follow-up persons with mental health issues in the community. MATERIALS AND METHODS: The study was conducted based on a sequential exploratory design in two phases: the development and the validation phases. An extensive literature search was done, and the themes derived from the two focus group discussion (FGD) and three direct interviews, and the inputs from the mental health experts were used to design the KSIM questionnaire. A panel of 17 experts validated the KSIM questionnaire through item-level content validity index (I-CVI) and scale-level CVI (S-CVI) for content validation, and the reliability test was done using the intraclass correlation coefficient ICC test-retest method. RESULTS: The draft version-1 of the KSIM questionnaire showed high content validity of individual items (I-CVI range: 0.82-1.00) and high overall content validity (S-CVI = 0.95), and suggestions from the experts were incorporated. The KSIM questionnaire consists of 30 multiple choice questions and 10 case vignettes. The KSIM questionnaire has a very good test-retest reliability using the single measure two-way mixed absolute agreement ICC value 0.97 with 95% CI. CONCLUSIONS: Using an iterative approach, the development and validation of the KSIM questionnaire demonstrated high I-CVI and S-CVI with good ICC test-retest reliability to assess the knowledge of primary care nurses on screening and identification, referral and follow-up of a PMI in the community. Primary care nurses' knowledge on how to screen for and identify people with mental health issues in the primary care setting can be evaluated with the help of the KSIM questionnaire, and providing need-based training may help to reduce the time taken for people with mental illness to receive professional help.

Effectiveness of intervention package on knowledge and attitude regarding functional needs and quality of life of elderly patients with psychiatric illness, among nursing interns.

OBJECTIVE: To develop and assess the effectiveness of the intervention package on knowledge and attitude regarding meeting the functional needs and improving the quality of life of elderly patients with psychiatric illness, among nursing interns. MATERIALS AND METHODS: The study was carried out among 60 nursing interns of a tertiary government mental health setting. After the pretest, the educational intervention package on functional needs and quality of life of elderly patients with psychiatric illness was administered to the study group in four sessions. Posttest data collection was performed using the same questionnaires after 2 weeks after the last session. RESULTS: There was a statistically significant improvement in the knowledge and attitude of nursing students following the sessions of the intervention package. Pretest data showed that there is a positive correlation between the knowledge and attitude of study subjects. Overall knowledge has significantly improved after attending the intervention program (Z = 6.701, P < 0.001). Moreover, the overall attitude level has significantly improved after attending the intervention program (Z = 6.741, P < 0.001). CONCLUSION: The educational intervention package on functional needs and quality of life of elderly patients with psychiatric illness was effective in improving the knowledge and attitude regarding functional needs and quality of life of elderly patients with psychiatric illness, among nursing interns. Similar packages may be incorporated into the nursing curriculum in training future nurses for their better practice in this area.

Effectiveness of anger management program on anger level, problem solving skills, communication skills, and adjustment among school-going adolescents.

BACKGROUND: Anger is a natural feeling which is essential for survival, however, which can impair functioning if it is excessive. Adolescents need to be equipped with skills to cope with their anger for the promotion of their health and safety. This study aims to examine the effectiveness of anger management program on anger level, problem solving skills, communication skills, and adjustment among school-going adolescents. MATERIALS AND METHODS: An experimental, pre-test-post-test control group design with a multistage random sampling was adopted to select 128 school-going adolescents aged between 13 and 16 years. Experimental group received six sessions of anger management program, while control group received one session on anger management skill after the completion of post-assessment for both the groups. Sessions included education on anger, ABC analysis of behavior and relaxation training, modifying anger inducing thoughts, problem solving, and communication skills training. Assessment done after the 2 months of anger management program. Data were analyzed through descriptive and inferential statistics. RESULTS: Study reveals the improvement in the problem solving skills (81.66 ± 4.81), communication skills (82.40 ± 3.82), adjustment (28.35 ± 3.76), and decreased anger level (56.48 ± 4.97). Within the experimental and between the experimental and control group, post-test mean scores differed significantly (P < 0.05). CONCLUSION: The results revealed that the anger management program was effective in decreasing anger level and increasing problem solving skills, communication skills, and adjustment among school-going adolescents.

Development and Validation of Clinical Schedule for Primary Care Psychiatric Nursing (CSP-N) for Primary Care Nurses.

Introduction: As per the World Health Organization's mental health report for 2022, nearly a billion people have mental health issues, and 82% of them are in low and middle-income countries where mental health services are largely absent. For the successful integration of mental health into primary health care, proper training and education of primary care professionals are mandatory. Primary care nurses are in an excellent position to screen, identify, dual collaboration for treatment planning/referral, and follow-up of persons with mental illness (PMI), but they often lack the confidence and competence to tackle mental health problems. The study aimed to develop and validate the clinical schedule for primary care psychiatric nursing (CSP-N). Materials and Methods: It is conducted in two phases: the development and validation phases. An extensive literature search has been conducted, and the ten themes derived from the two-focused group discussions and three-direct one-to-one interviews and input from mental health experts were used to design the CSP-N. The CSP-N was checked for content validity by a panel of 17 experts using the item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI). Results: The draft version 1 of the CSP-N showed high content validity for individual items (I-CVI range: 0.82 to 1.00) and high overall content validity (S-CVI = 0.95), and suggestions from the experts were incorporated. The CSP-N was developed in four modules. The single-measure two-way mixed absolute agreement ICC value was calculated (for 32 subjects) for the reliability test, and the ICC value was 0.97 with a 95% CI (0.94, 0.99). Conclusions: Using an iterative approach, the development and validation of the CSP-N demonstrated high I-CVI and S-CVI for screening and identification, dual collaboration for the treatment plan, referral, and follow-up of a person with mental illness by the nurses in the community.

Effectiveness of agile methodology on metacognitive ability, and clinical performance among nursing students-An interventional study.

BACKGROUND: The emerging trend focuses on the need for an active agile method in the nursing curriculum. It helps to improve student engagement, the interaction between the students and teachers, higher-order thinking, teamwork, and practical skills. This study was done to assess the effectiveness of agile methodology on metacognitive ability and clinical performance among nursing students. MATERIAL AND METHODS: In this interventional study, two groups of the pre-post design were adopted. Each college was considered a cluster. By using the chit method, the colleges (four) were randomly selected for the experimental and control groups. To avoid contamination, all the fourth-year students were included either in the experimental group (133) or the control groups (132), respectively. The pretest was conducted using a metacognitive awareness inventory (metacognitive ability (MA)) and an objective structured clinical examination (OSCE) tool (clinical performance (CP)) in the experimental and control groups. Leaders were selected using leader attribute inventory (leadership ability (LA) in the pretest and posttest 2 among the experimental and control groups before the agile teaching. By using agile methodology, the newborn course was taught for 21 days in the experimental group. To assess the effectiveness of agile methodology, the control group was not given any teaching. Posttests were conducted immediately and after 1 week to assess the MA and CP in the experimental and control groups. The control group had agile training for 10 days after the posttests to understand the newer agile methodology. The data were analyzed by using SPSS version 28. Descriptive and inferential statistics were used to assess the data for effectiveness. RESULTS: The result showed that there is an improvement in the metacognitive ability (MA) score and clinical performance score over time in the experimental group (P < 0.001). CONCLUSION: The study finding supports that incorporating agile methodology in education impacts the metacognitive ability and clinical performance among nursing students. However, the teacher must be familiar with the methodology while incorporating agile in teaching.

Sexual and reproductive health problems among women with mental illness attending tertiary care psychiatric outpatient clinic in India: A cross-sectional study.

Objectives: Sexual and reproductive health (SRH) is a vital concern among women with mental illness (WMI) due to the increased risk for unplanned pregnancy, sexually transmitted infections (STIs), and poor obstetric outcomes. Objective of the study was to explore the current use of family planning (FP) methods, symptoms of STIs and sexual dysfunction among WMI. Materials and Methods: This descriptive study involved 404 WMI of reproductive age (18-49 years) attending tertiary care psychiatric outpatient clinics in India. During face-to-face interviews, centers for disease control and prevention (CDC)-reproductive health assessment toolkit-FP questionnaire, STI questionnaire and Female sexual function index (FSFI) were used to collect the data. Results: Of 404 WMI, 261(64.6%) were users, and 137 (33.9%) were non-users of FP methods. About 6(1.5%) WMI did not respond FP methods question. Female sterilization was the highest among the users, 244(93%). Among non-users, 100 (73%) were unaware of choosing the effective method of FP. Most of the WMI, 377(93.3%), were unaware of STIs. The symptoms of STI reported include unusual genital discharge 62(15.3%) and genital ulcers/ sores 58(14.4 %). Most of them, 76(63.3%), were not on any treatment. The most common reason for not taking treatment was feeling ashamed 70(92.1%). Female sexual dysfunction was reported in 176(43.6%). Most of the WMI had difficulties in the arousal domain 288(71.3%), followed by low desire 233(57.7%) and dissatisfaction 186(46%). Conclusion: Most WMI underwent sterilization. Non-users of FP methods were not aware of choosing the effective method. Awareness about STIs was poor, and feeling ashamed was the primary reason for not availing of medical help. Nearly half of the WMI reported sexual dysfunction, among which arousal difficulties, low desire and dissatisfaction were common. Health professionals need to increase awareness about FP methods and symptoms of STIs among WMIs. Women require appropriate counselling regarding SRH and treatment for sexual dysfunction.

The rationale and guiding principles to design a psychiatric curriculum for primary care nurses of India.

Background: The National Mental Health Survey reports a huge treatment gap for all mental disorders. There is an acute shortage of mental health professionals in India. Hence, there is a dire need to support task-shift interventions by nurses in providing non-pharmacological interventions for persons suffering from mental health issues. The traditional psychiatric nursing curriculum emphasizes nurses' knowledge and skills rather than their competency in providing mental health care. We designed an innovative, digitally driven, modular-based primary care psychiatry program for nurses (PCPP-N) to incorporate mental health with physical health and emphasize redesigning nursing practice. In this paper, we discuss the rationale and guiding principles behind designing the curriculum of PCPP-N. Discussion: The PCPP-N program is based on nine guiding principles to provide skill-based, pragmatic, and feasible modules of a higher collaborative care quotient (CCQ) and translational quotient (TQ) that are essential for upskilling primary care nurses. In this program, nurses are trained through telemedicine-based 'on-consultation training' augmented with collaborative video consultations. A tele-psychiatrist/tele-psychiatric nurse will demonstrate how to screen, identify, and plan treatment for patients with psychiatric disorders from patients coming for general medical care using the manual Clinical Schedules of Primary care psychiatry Nursing (CSP-N). The CSP-N manual includes a screener, simplified diagnosing guidelines relevant for nurses and primary care settings, nursing management, pharmacological management, and related side effects, counseling, and follow-up guidelines. This program helps the nurses in identifying the most commonly prevalent adult psychiatric disorders presenting to primary care. Conclusion: This PCPN curriculum contains pragmatic modules with higher CCQ and TQ. This curriculum is dynamic as the learning is interactive. Upskilling primary care nurses in integrating mental health with physical health may reduce the mental health burden. Further, the policymakers and administrators plan to integrate mental health along with physical health in national health programs.

An audit of initial six years of 5885 telepsychiatric direct video consultations: Findings from "benefits of savings" analysis and the effect of COVID-19 pandemic.

Background: Telepsychiatric direct video consultations (DVCs) meant for continuity of care began in 2017 and continued during the coronavirus disease 2019 (COVID-19) pandemic. Telemedicine-based consultation gained its long-due importance during the COVID-19 travel restriction, despite its existence for a long. The authors intend to share the utility and growth of the initial six years of live telepsychiatric DVCs from an academic hospital in India and also plan to understand the effects of the COVID-19 pandemic on its growth and report findings from an innovative "benefits of savings" (BOS) analysis from these clinics. Methods: A first six years of medical audit of the files and registers of telepsychiatric DVCs from two kinds of continuity of care clinics during 2017-2022 is performed. An analysis of 4991 (84.8%) live DVCs is successfully conducted for 1570 patients from the 5885 scheduled appointments. Year-on-year (YOY) growth and BOS analysis of successful DVCs from these clinics were performed. Results and Discussion: The growth suggests a gradual increase in DVCs yearly. The BOS analysis suggests its increased acceptability, feasibility at both user and provider ends, and possible cost-effectiveness of these video clinics. YOY analysis suggests a natural growth of these clinics than from the effect of the COVID-19 pandemic, except for an initial surge in 2020 and 2021 and observing stabilization effect by 2022. Conclusion: In the authors' understanding, this is the largest study of providing DVCs from India, irrespective of any medical/surgical specialty. The video/remote clinics could be an alternative model for regular follow-ups in ensuring the continuity of care among patients with psychiatric disorders. These clinics also saved significant travel time, travel distance, and travel costs for the patients that could have occurred for their in-person consultations.

Impact of structured physical activity program on the level of functional ability of Persons with Mental Illness.

BACKGROUND: A structured physical activity program has many health benefits. Physical activity improves the functional ability of a patient with mental illness as an adjunctive treatment. This study aimed to evaluate the efficacy of a physical activity program on the level of functional ability of patients with mental illness. MATERIALS AND METHODS: A pre-experimental research design and one group pre-post design were adopted. Thirty-one in-patients with mental illness who met the inclusion criteria were recruited for the study using convenient sampling. Baseline data were collected using sociodemographic and illness profiles developed by the researcher and validated by the experts. Functional ability and illness severity were assessed using the standardized World Health Organization Disability Assessment Schedule (WHODAS) (36-item version) and the Clinical Global Improvement Scale. Pretest, i.e., intervention with structured physical activity, was administered for 40 consecutive days. A posttest was given 30 days after the intervention ended to assess the impact of the structured physical activity program on the level of functional ability among the study participants. RESULTS: The impact of structured physical activity on functional ability was measured using the WHODAS 2.0, a 36-item version. The paired Sample t-test and the Wilcoxon Rank test analyzed the data. There was a significant improvement in the overall functional ability of study participants at P = 0. 001. CONCLUSION: The study findings support that structured physical activity substantially impacts functional ability among patients with mental illnesses.

Effectiveness of Parent-to-Parent Support Group in Reduction of Anxiety and Stress Among Parents of Children With Autism and Attention Deficit Hyperactivity Disorder.

Background: Parental interventions are efficacious and robust in managing children's behavioral problems. Yet, research addressing their role in parental stress and anxiety is sparse. Our first aim was to assess the extent of anxiety and stress among parents of children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The second was to assess the effectiveness of a parent-to-parent support group for addressing the stress and anxiety among those parents. Methods: We selected a single group pretest posttest design. We recruited 24 parents from the two in-patient facilities of child and adolescent psychiatry. The intervention consisted of a parent-to-parent support group. We assessed parental stress and anxiety before and after the intervention. Results: The differences in anxiety and stress scores prior to and after the intervention were statistically significant (P < 0.001). Before the intervention, low level of parents' education and lower family income had a statistically significant relationship with higher parental stress. Also, parents who were employed had lesser anxiety. Conclusion: The parent-to-parent support group effectively reduced stress and anxiety among parents of children with ASD and ADHD. These are preliminary findings. The lack of a control group is a major limitation.

Beliefs and expectations on digital learning and examinations among adult learners of a tertiary level health-care institution.

BACKGROUND: Coronavirus disease 2019 (COVID-19) constrained the regular teaching in educational institutions and hampered the teaching-learning process across the globe. E-learning method is widely used in higher education in the current situation. the objective is to assess the beliefs and expectations of the students on e-learning among adult learners of a tertiary level health-care institution. MATERIALS AND METHODS: A single group pre-post design was adopted. Microsoft Go two-in-one devices were used to find the effectiveness of e-learning, including digital exam solution. Depending on the availability of device, 25 participants were selected for the study from three different steams. A 5-point Likert scale was used for assessing the quality, adoptability, and acceptance of digital education developed by the researchers. Chi-square/Fisher's exact or McNemar's test was used to test the association between independent or related categorical variables. Comparison of the average score between different courses was performed using the Kruskal-Wallis test. RESULTS: Twenty-two participants who completed the final assessment were retained for the analysis. Majority of the participants believed that e-learning helps to achieve personal learning goals or objectives and bridge skill or knowledge gaps and caters to learning preferences. However, the overall quality score across the study groups was found to be statistically insignificant (Kruskal-Wallis statistic: 1.26; P value: 0.533). CONCLUSION: The findings show that the adult learners in higher education, irrespective of their age differences, believe that intense e-learning support with Microsoft Go two-in-one device has a complementary effect on their learning outcome.

Psychological preparedness for pandemic (COVID-19) management: Perceptions of nurses and nursing students in India.

INTRODUCTION: The growing COVID-19 pandemic has posed a great threat to millions of people worldwide. Nurses and nursing students are an important group of health professionals who are most likely to face many challenges in this unprecedented scenario. The present study aimed at exploring nurses' and nursing students' perception of psychological preparedness for the pandemic (COVID-19) management. MATERIALS & METHODS: The study employed a quantitative cross-sectional online survey research design. Purposive sampling was used with an attempt to represent the entire nurses (i.e. nursing officers, nurse administrators and nursing teachers) and nursing students' group of India. The survey link including the questionnaires was shared to their email ID and they were invited to participate in the study. Data were collected using Psychological Preparedness for Disaster Threat Scale (PPDTS)-Modified, General Self Efficacy (GSE) Scale, Optimism Scale and Brief Resilient Coping Scale (BRS). Totally 685 responses were received and 676 forms were completed which were analyzed using SPSS software (version 24). RESULTS: The mean age of the subjects was 31.72±9.58 years. Around 20% of the subjects previously had some kind of psychological training and 4% of the subjects had taken care of persons with COVID-19. Findings revealed that mean score for PPDTS, GSE, BRCS and Optimism was 73.44±10.82, 33.19±5.23, 16.79±2.73 and 9.61±2.26 respectively indicating that the subjects had moderate level of psychological preparedness, self-efficacy and resilience but higher level of optimism. Psychological preparedness, self-efficacy, optimism and resilience were positively correlated to each other. Self- efficacy, optimism, and resilience emerged as predictors of psychological preparedness. CONCLUSION: The findings suggested that self-efficacy, optimism and resilience can be considered as predictors for psychological preparedness in pandemic management. Appropriate training could influence self-efficacy while programs addressing resilience and coping may strengthen psychological preparedness which can help in further management of ongoing pandemic.

The Effectiveness of Nurses Implemented Music Add-on Therapy in Children with Behavioral Problems.

BACKGROUND: Increasing rates of behavioral problems among children in India necessitates newer ways of managing them with medical and nonmedical approaches. Music add-on therapy is a method for treating mental disturbances. This study examines the effectiveness of music add-on therapy in managing children with behavioral problems. METHODS AND MATERIALS: A randomized controlled design was adopted with a random allocation of 40 children (20 each in experimental and control groups) aged between 6 and 12 years with behavioral disorders as per the International Statistical Classification of Diseases and Related Health Problems (ICD)-10. After the pretest, both the groups received treatment as usual (TAU), while the experimental group alone additionally received music add-on intervention with eight Hindustani ragas for 3 weeks. As clinical outcome measures, we used the Childrens Global Assessment Scale, Nisonger Child Behavior Rating Form typical IQ (NCBRF-TIQ) version, and visual analogue scale (VAS) for a parent to monitor the behavioral improvement. RESULTS: Children exposed to the music add-on therapy had improved score in the Children Global Assessment Scale (CGAS) and the VAS as compared with the control group (F [2,76] = 34.307, P < 0.001 and F [2,76] = 72.4, P < 0.001, respectively). Further, the NCBRF-TIQ version revealed improvement in positive social behavior (F [2,76] = 13.089, P < 0.001) and reduction in problem behaviors in the experimental group. CONCLUSION: Music add-on therapy is effective in improving positive social behavior and reducing problem behaviors among children.