Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal.

BACKGROUND: Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal. METHODS: A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS). Thirteen caregivers of COVID-19 positive patients were purposively selected from April to June, 2022. Face-to-face interviews were conducted at a caregiver residential facility using the interview schedule developed by the department for the purpose of data collection after obtaining ethical clearance from the Institutional review committee of BPKIHS. Data were audio recorded and manually analyzed. RESULTS: Among the 13 caregivers, six were male and seven were female. The findings were categorized into five domains: challenges encountered, changes in physical and mental health, changes in roles and responsibilities, positive experiences, and strategies to ease caregiving tasks. Major challenges included financial burdens, communication problems, stigmatization, Insecurity, substandard accommodation, and visitor restrictions. Caregivers reported negative emotions, unmet physical health needs, and shifts in family and occupational roles. Despite these challenges, caregivers attempted to cope positively and acknowledged the efforts of healthcare personnel and other family members. Suggestions for improving caregiving included providing essential medical and basic services within the hospital, enhancing accommodation facilities, establishing proper communication channels, and allowing visitations. CONCLUSIONS: Caregivers of COVID-19 patients face significant challenges during the caregiving process. Enhancing hospital services, promoting effective communication, fostering positive attitudes, and ensuring a safe environment can facilitate caregiving tasks.

Attitude Towards Suicide among Caregivers of Patients Admitted with Suicide Attempt to a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Understanding the attitude of caregivers towards suicide attempters could be useful in suicide prevention. The objective of this study was to study attitude towards suicide among caregivers of patients with suicide attempt admitted to a tertiary care hospital in Nepal. METHODS: A descriptive cross-sectional study was conducted with 52 caregivers of patients with suicide attempt who had been admitted to a tertiary care hospital of Nepal after obtaining ethical clearance from Institutional Review Committee (ref. IRC/0797/016). Data were collected through interviews using the Attitude towards Suicide Questionnaire and in-depth interviews conducted on five caregivers using the interview framework developed in the department for the purpose. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Content analysis was used for qualitative data. RESULTS: Majority of the caregivers 34 (65.4%) had unfavorable attitude towards suicide. Caregivers reported that mental and chronic physical illness, financial difficulty, working environment, and social factors such as undue pressure and failure to perform the task, difficulty maintaining the relationship, abuse, and neglect could be some of the possible causes of suicide. Caring and understanding attitude of family members, health professionals, and society towards the suicidal individuals providing appropriate training and education to the public would help in reducing the stigma and burden of suicidal patients. CONCLUSIONS: The overall attitude of the caregivers was unfavorable. Interventions targeted towards improving attitude towards suicide could be helpful in suicide prevention.

Caregiving Stress among Caregivers of Patients admitted with Suicidal Attempt.

BACKGROUND: Family caregivers play a key role in preventing suicide attempts. The objective of this study was to study the caregiving stress of the patients admitted with suicide attempt at a tertiary care hospital in Nepal. METHODS: A mixed method study was conducted with 52 family caregivers of suicidal people who had been admitted at B. P. Koirala Institute of Health Sciences, Dharan with history of suicide attempt. Data were collected through interview using Kingston Caregiver Stress Scale and in-depth interview was conducted on five family caregivers using interview framework developed in the department for the purpose. RESULTS: The mean caregiving stress score was 29.84(SD=5.11), with the mean score of score 22.0 (±3.9) in caregiving issues, 4.3(±1.9) in family issues and 3.5(±0.9) in financial issues respectively. Majority (65.4%) of the caregiver had perceived stress scores above the mean score. Caregiver's stress was significantly associated with age (p= 0.023), marital status (p= 0.008) and patient's mode of attempt (p=0.035) with stress level being higher in those with older age, married and hanging as the mode of suicide attempt. In-depth interview showed that financial difficulties, emotional and physical problems, difficulty maintaining daily activities, and stigma related problem seem to significantly increase caregiver's stress. CONCLUSIONS: The study showed overall stress level of caregivers was high.

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.

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).

Cognitive schemas among mental health professionals: Adaptive or maladaptive?

OBJECTIVES: Maladaptive cognitive schemas can lead to biases during clinical assessment or psychotherapeutic interventions. This study aimed to explore the cognitive schemas among mental health professionals. MATERIALS AND METHODS: 100 mental health professionals, of both genders, equally divided between psychiatrists, psychologists, social workers, and psychiatric nurses, were approached and administered the Young Schema Questionnaire - Short Form after written informed consent. RESULTS: Males had higher maladaptive schemas than female respondents across all schema domains, viz., disconnection/rejection, impaired autonomy, impaired limits, other-directedness, and overvigilance (P ≤ 0.05). Psychiatrists had higher maladaptive schemas than psychologists (P ≤ 0.05). Age was weakly but positively corelated with the schemas of self-sacrifice (P = 0.038) and unrelenting standards (P = 0.002). CONCLUSIONS: Mental health professionals also may have maladaptive schemas, which needs to be addressed through schema therapy.