Nepal needs Continuing Professional Development for Re-registration in Nursing and Midwifery.

The nursing and midwifery profession needs to stay up to date with the latest developments.  In this Viewpoint, we shall be referring to 'nurses' and 'nursing' to mean 'nurses and midwives' and 'nursing and midwifery' respectively. Nurses must continue to update their skills and competences to meet changing future population health needs effectively and safely. However, the reality is that many staff are reporting difficulty accessing and completing Continuing Professional Development (CPD) in all settings. Keywords: CPD; midwifery; nursing; post-registration education; training.

The supportive care needs survey short form 34 (SCNS-SF34): translation and cultural adaptation into the Nepali language among patients with cervical cancer in Nepal.

BACKGROUND: A questionnaire developed in one language must be translated and adapted when it will be used with patients speaking a different language and care should be taken to maintain equivalence between the source language (SL) version and its translated version. The objective of this study was to test the linguistic and cultural validity of a Nepali language version of the Supportive Care Need Survey - Short Form 34 (SCNS-SF34) used with the Nepali population. METHODS: Translation of the SCNS-SF34 was carried out by following Beaton's guidelines and Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) by a research team. The translated version was administered to patients with cervical cancer in Nepal. The following steps were performed as part of the study: translation, content validity assessment, reliability assessment and measurement of errors. RESULTS: The study reports item content validity (I-CVI) was > 0.78 and scale content validity (S-CVI) was - 0.89, 0.91 and 0.90 respectively in semantic, cultural, and conceptual aspects. The study found a content validity ratio (CVR) of 0.9 to 1, Cronbach's α of 0.90, correlation significant at the 0.01 level (2-tailed), and clarity of the questionnaire at 91.29%. The standard error of measurement (SEM) and small detectable changes (SDC) for overall care need scores were measured 2.70 and 7.47 respectively. All items were accepted as per the original SCNS-SF34. Following the respondents' suggestions, simpler Nepali words were chosen in some items to replace the words in the preliminary Nepali version of SCNS-SF34. CONCLUSION: Preliminary findings show that the Nepali translation of SCNS-SF34 is practical and applicable to the Nepali population. Financial supportive care needs, supportive care for caretakers and problems during patient hospital stays are essential to include in the questionnaire to further explore supportive care needs.

Nurses' knowledge and attitudes regarding children's pain assessment and management in Nepal.

Pain is frequently experienced by children in hospital, and international guidelines for appropriate pain assessment and management are available. Optimal management of paediatric pain has important long-term health, psychosocial, and economic benefits. However, evidence indicates that globally there are deficits in nurses' understanding of paediatric pain assessment and management. This study explored knowledge and attitudes regarding paediatric pain assessment and management among nurses at a tertiary children's hospital in Nepal. In this cross-sectional study all 140 nurses at a tertiary children's hospital in Nepal, were invited to complete the validated Paediatric Nurses Knowledge and Attitudes Survey. Findings revealed substantial deficits in nurse's knowledge and erroneous attitudes towards pain assessment and management in children. Test scores ranged from 14% to 56%, with mean scores of 38%, with no nurses achieving a recommended pass score of 80% regarding knowledge and attitudes in paediatric pain management. Consistent with previous research, nurses had insufficient knowledge and attitudes that did not reflect best practice regarding pain assessment and management in children. Education programmes targeting both trainees and registered nurses are essential to enable nurses to deliver evidence-based care and improve outcomes for children and their families.

Stress, Anxiety, Depression and Their Associated Factors among Health Care Workers During COVID -19 Pandemic in Nepal.

BACKGROUND: Frontline Health Care Workers are at risk of developing mental and psychological distress during Corona virus disease 2019 pandemic. This study aimed to assess level of stress, anxiety, depression and their associated factors among health care workers during Corona virus disease 2019 pandemic in Nepal. METHODS: This is a web based cross-sectional survey conducted among 404 Health Care Workers during early phase of Corona virus disease 2019 pandemic. The participants were selected using convenience sampling technique and were invited to participate via various online networks. Depression, anxiety and stress were assessed using the Depression Anxiety Stress Scale-21 (DASS-21) and their associated factors were measured using structured questionnaires. Multivariable logistic regression was carried out to determine the associated factors. RESULTS: The symptoms of stress, anxiety and depression among health care workers were found to be 28.9%, 35.6% and 17.0% respectively. Females were found to be 2 fold more likely to have anxiety and depression than male. Nurses were found to be two times more likely to have anxiety than doctors. Laboratory personnel were almost three folds more likely to have anxiety than doctors. Health care workers with insufficient/ no PPE were almost three fold more likely to have depression. health care workers working in high-risk areas had almost 2 fold higher odds of having depression. CONCLUSIONS: Health care workers experienced symptoms of stress, anxiety and depression in varied level of severity. This experience was higher among the nurses and laboratory workers than doctors. Pandemic preparedness assuring PPE and appropriate psychological interventions may be beneficial to promote mental health and well-being of health care workers.

Perceived Burden in Caregivers of Children with Autism Spectrum Disorder.

BACKGROUND: Autism Spectrum Disorder is a lifelong developmental disorder that affects children and results in deficit in social interaction, communication and display of unusual pattern of behavior. Though caregiving is a normal parental duty, providing intensive care to a child with long-term problem is burdensome and impacts both physical and mental health of caregivers. The aim of this study was to obtain a picture of burden among caregivers raising children with Autism Spectrum Disorder. METHODS: We conducted a descriptive cross-sectional study to assess the burden of caregiving among sixty one parents of children with Autism Spectrum Disorder in the Kathmandu Valley, Nepal, using purposive sampling technique. The burden perceived by caregivers was assessed using standard tool Zarit Burden Interview-22. RESULTS: Average burden score was 41.49±12.25 which indicates that caregivers experienced moderate to severe range of burden. Level of education, anxiety and depression was found to be significantly associated with burden of caregiving. CONCLUSIONS: The study concluded that the burden of caregiving is most remarkably associated with emotional status and social life of the caregivers.

Psychosocial problems among individuals with substance use disorders in drug rehabilitation centers, Nepal.

BACKGROUND: Substance use is associated with numerous undesirable short and long term consequences. The individual not only suffer from physical and psychological problems but also loses the ability to interact with family, peers and society. The present study aims to identify the psychosocial problems and associated factors among individuals with substance use disorders. METHODS: The study was conducted using descriptive cross sectional research design in different drug rehabilitation centers of Nepal. Probability proportional to size sampling technique was used to select the drug rehabilitation centers and individuals diagnosed with substance use disorder but free from any substance withdrawal features, admitted in rehabilitation centers within 3 months and clients above 15 years of age were included in the study (N = 204). A standard tool Drug Use Screening Inventory-Revised was used to assess the psychosocial problems and the scores ranged from 0 to 100. The data were analyzed using descriptive and inferential statistics. Linear regression analysis was conducted to identify the predictors of psychosocial problems. RESULTS: The mean and standard deviation of overall psychosocial problems scores was 60.42 ± 19.44. Among different domains, more problems were found in substance use domain (75.00 ± 21.43) followed by school performance (64.60 ± 25.53), behavior pattern (64.53 ± 24.44), peer relationship (64.49 ± 24.91), social competence (61.30 ± 22.60), psychiatric disorder (56.83 ± 23.39), family system (48.28 ± 23.72) and work adjustment (45.90 ± 29.88) domains. Types of substance use, mode of substance use and age of initiation of substance use were the significant predictors of overall and most of the domains of psychosocial problems. CONCLUSION: Substance use poses significant impact on individual's psychological and social wellbeing. Individuals using injecting drugs, initiating substances early in life, using substances many times in a day and using both licit and illicit substances had more psychosocial problems. Hence, treatment centers should take this into account.

Golgi enlargement in Arf-depleted yeast cells is due to altered dynamics of cisternal maturation.

Regulation of the size and abundance of membrane compartments is a fundamental cellular activity. In Saccharomyces cerevisiae, disruption of the ADP-ribosylation factor 1 (ARF1) gene yields larger and fewer Golgi cisternae by partially depleting the Arf GTPase. We observed a similar phenotype with a thermosensitive mutation in Nmt1, which myristoylates and activates Arf. Therefore, partial depletion of Arf is a convenient tool for dissecting mechanisms that regulate Golgi structure. We found that in arf1Δ cells, late Golgi structure is particularly abnormal, with the number of late Golgi cisternae being severely reduced. This effect can be explained by selective changes in cisternal maturation kinetics. The arf1Δ mutation causes early Golgi cisternae to mature more slowly and less frequently, but does not alter the maturation of late Golgi cisternae. These changes quantitatively explain why late Golgi cisternae are fewer in number and correspondingly larger. With a stacked Golgi, similar changes in maturation kinetics could be used by the cell to modulate the number of cisternae per stack. Thus, the rates of processes that transform a maturing compartment can determine compartmental size and copy number.