Psychosocial responses to COVID-19 among nurses in two hospitals: a mixed method study at Eastern Nepal.

BACKGROUND: Most documented studies have focused on mental health status of health care workers during the pandemic but there are very few studies, focusing on mitigation of mental health problems among nurses. AIM: To study psychosocial responses to COVID-19 and the effectiveness of intervention among nurses. MATERIALS AND METHODS: A mixed-method study was conducted, including 278 nurses from two COVID-19 hospitals of the province by purposive sampling. Depression, anxiety and stress and a composite measure of personal financial burden scales for quantitative; and interview guide for qualitative data were used. A psychosocial strengthening session was introduced and the effectiveness of the program was assessed after 4-5 weeks of intervention. RESULTS: Mild, moderate and severe depression was found among 13.7%, 9.4% and 1.1% of the participants correspondingly. Mild, moderate, severe and extremely severe anxiety was found among 21.2%, 8.6%, 3.2% and 2.2% of the participants respectively. Stress was mild among 9% and moderate in 1.4% of the participants. Lack of PPE and fear of transmitting infection were found as frequent causes of problems. Mean scores of depression, anxiety and stress were significantly decreased after the psychosocial strengthening program. CONCLUSION: Depression, anxiety and stress are common issues of nurses. Common causes of problems were lack of resources, fear of being infected and fear of transmitting to family members. The psychosocial strengthening program was effective in reducing the problems.

Perception of the learning environment among the students in a nursing college in Eastern Nepal.

BACKGROUND: Learning environment is an important base for learning processes of students and for preferences of future workplaces. It is considered as an essential factor in determining the success of an effective curriculum and the students' academic achievements. This study attempts to assess the perception of learning environment among the nursing students. METHODS: A descriptive cross-sectional study design was used to conduct the study among 122 nursing students studying at B.P. Koirala Institute of Health Science. Data were collected following total enumerative sampling method using a self-administered questionnaire. Dundee Ready Educational Environment Measure (DREEM) inventory tool was used to assess the perception of learning environment. Descriptive statistics (frequency, percentage, mean and standard deviation) was used to describe the demographic and other related variables. One way Analysis of Variance (ANOVA) was used to find out the difference in the overall scale score and its subscales across the selected socio-demographic variables (age, ethnicity, residence, year of enrollment) of the respondents. RESULTS: The mean age of the students was 21 ± 1.46 years. Majority of the students were from Province no. 1 (57.4%) and largely from Sunsari district (25.4%). First year students were found to be more satisfied (68.23%) with the educational environment (136.45 ± 16.93) compared to student of other years. Academic self-perception (21.94 ± 3.42) was the highest scoring subscale (68.57%) while the social self-perception (16.43 ± 2.96) was the lowest (58.66%). The overall DREEM score (131.25 ± 15.82 out of 200) indicated that perception of learning environment among the students was positive. Despite overall positive perception, students perceived that the teachers were authoritative and there is lack of good support system for the students at the time of stress. The total DREEM score varied significantly between the years of enrollment (p < 0.05). CONCLUSION: The current study showed positive perception of learning environment which varied significantly according to the year of enrollment. However improvements are required across all the five domains for the high quality educational environment. Future qualitative studies are recommended to confirm and to have in-depth understanding of this finding.

Burden and Its Predictors among Caregivers of Patient with Epilepsy.

BACKGROUND AND PURPOSE: Epilepsy is a chronic unpredictable debilitating condition. Epilepsy has great impacts not only on patients with epilepsies but also the persons around them. Burden among caregivers is understudied area. In view of the dearth of literature or studies focused on caregivers of children with epilepsy in Nepalese context, this study is expected to assess burden and its predictors among caregivers of children with epilepsy. METHODS: A total of 106 caregivers were interviewed using purposive sampling technique. The Zarit Burden Interview Scale short version was used to assess burden and Hospital Anxiety Depression Scale was used to assess anxiety and depression. Data were analysed using SPSS ver. 16.0. Chi-square test, multinomial logistic regression and linear regression analysis were done for analysis of inferential statistics to find out the predictors of burden. RESULTS: Majority of the caregivers (71.7%) were females and 64.2% of caregivers were mothers of children. Majority of responders (77.4%) were Hindus. Mild to moderate burden was found in 27.4% and high burden was found in 14.2% of the caregivers. Borderline anxiety, borderline depression, anxiety and depression were present in 7.5%, 8.5%, 6.6%, and 6.6% caregivers respectively. Burden was significantly higher in caregivers of epileptic children with poorly controlled seizure (p=0.003) and with co-morbidities (p=0.009). Similarly, burden score had significant positive correlation (p=0.001) with depression and significant negative correlation (p=0.005) with age of onset of epilepsy in children. CONCLUSIONS: Burden, anxiety and depression are common problems in caregivers of children with epilepsy. Poorly controlled seizure, presence of associated comorbidities, younger age of onset of seizure in children and presence of depression in caregivers are the important factors that predict burden among caregivers of children with epilepsy.

Physical restraining: Nurses knowledge and practice in Tertiary Care Hospital of Eastern Nepal.

AIM: The aim was to assess the level of knowledge and practice on physical restraints. DESIGN: A descriptive cross-sectional study design was adopted. METHODS: A total enumerative sampling technique was used to select 117 nurses working in ICU, medical wards, psychiatric ward and emergency unit of Tertiary Care Hospital, Nepal. After obtaining written consent from each participant, self-administered questionnaires on socio-demographic profile, knowledge and practice about physical restraints were distributed. RESULTS: Most nurses (55.6%) were from age group of 18-25 years. Most of the participants (82.1%) had completed their Diploma Nursing, and 33.3% of the nurses were working in the ICU. Maximum of the participants (74.4%) had previous exposure to physical restraints. In knowledge of physical restraints, the score of 52.1% showed above the median range (Median [IQR] = 43 [54-30]). In the case of practice, 54.7% of the nurses showed adequate practice (mean = 80.1, SD 7.7).