RESUMO
Background: Dealing with trauma has always been challenging for people from all walks of life. Moreover, traumas like Motor Vehicle Accidents (MVA) are sudden and can be life-threatening, which further raises the concern and thus requires healthy adaptation. Considering the lack of data on the coping strategies of accident survivors in India, this study was undertaken to assess the coping strategies adopted by MVA survivors. Methods: Cross-sectional survey was conducted at tertiary care institution in Uttarakhand (India) during 2019-2020. A total of 250 MVA survivors were selected through total enumerative sampling and assessed for posttraumatic stress disorder (Posttraumatic Stress Disorder Checklist (PCL)-5), depression (Zung self-rating depression scale), and coping strategies (Brief COPE questionnaire). Results: The mean score was highest for emotion-focused coping mechanism (32.84 ± 5.18) and lower for dysfunctional (26.18 ± 10.59) and problem-focused (18.47 ± 3.12) coping mechanisms. Religion (96.87%) and emotional support (87.25%) were among the frequently adopted coping styles, whereas denial and self-blame were the least adopted. A high correlation was found between depression and the three coping mechanisms (r = 0.83 [emotion-focused coping], 0.68 [problem-focused coping], 0.62 [dysfunctional coping]). Among the participants, 133 crossed the threshold for PTSD and/or depression. Conclusions: A commonly adopted coping strategy among MVA survivors is emotion-focused coping mechanism. Religion and emotional support are most prevalent because of family dynamics prevalent in countries like India.
RESUMO
BACKGROUND: Motor vehicle accidents (MVAs) are the leading cause of death and have also been proven debilitating for their survivors. In India, with poor road infrastructure and low maintenance, MVAs are quite apparent. With a significant focus of treatment on physical health, psychological consequences linked to these traumas are often neglected. AIM: The aim of this study was to estimate the prevalence of posttraumatic stress disorder and depression, as well as the determinants of these disorders among survivors of MVAs. MATERIALS AND METHODS: An institution-based, cross-sectional descriptive study was conducted among 250 survivors of MVA visiting a tertiary care center in Uttarakhand (India) during December 2019, recruited using total enumerative sampling. Data were collected with standardized and validated tools that consisted of sociodemographic information, Posttraumatic Stress Disorder Checklist 5, and Zung Self-Rating Depression Scale. Data were analyzed using SPSS version 23, including descriptive (frequency, percentage, mean, and mean percentage) and inferential statistics (Mann-Whitney, Kruskal-Wallis, and binary logistic regression). RESULTS: The prevalence of posttraumatic stress disorder (PTSD) was found to be 32.4%, and mild and moderate depressions were present among 14.4% and 6.4% of the study population, respectively. Witnessing death (odds ratio [OR] = 5.52; 95% confidence interval [CI] = 0.92-3.06), loss of valuables (OR = 2.62; 95% CI = 0.78-9.04), self-blame (OR = 6.06; 95% CI = 1.15-31.91), and perceived death threat (OR = 9.98; 95% CI = 5.89-46.85) acted as determinants in the occurrence of PTSD and depression. CONCLUSION: A considerably large proportion of the population suffered from psychiatric disorders following the trauma. These must be addressed with an urgent development of multidisciplinary teams incorporating mental health services across all hospitals' trauma units.
RESUMO
BACKGROUND AND AIM: Considering lack of data on clinical acumen and clinical practice readiness of graduating nurses in India; this cross-sectional survey was undertaken to assess the self-reported clinical practice readiness of graduating nurses from a selected state in India. MATERIALS AND METHODS: The survey was conducted at randomly selected public and private nursing institutes in Uttarakahnd, India, during June-July 2017. Total 173 final-year nursing undergraduates were selected through cluster sampling technique and they were asked to report their clinical competencies using a prevalidated and reliable tool, i.e. Comprehensive Nursing Competencies Questionnaire. RESULTS: The mean competencies score for basic nursing skills was reasonably high (236.5 ± 25.0). However, it was significantly low for the advanced nursing skills (148.7 ± 25.6) and selected basic nursing tasks such as perioperative care, elimination related interventions, and handling of medical equipment (recoding electrocardiogram and using defibrillator). Graduating nurses with younger age and longer duration of clinical placement had higher mean competency score in basic as well as advanced nursing skills (P < 0.05). Whereas, nurses studying at private nursing institutes had lower mean competency score for advanced nursing skills (P = 0.001). CONCLUSION: Clinical practice readiness of graduating nurses for basic nursing skills is good. However, it is seriously poor for the advanced nursing skills. This could be because of lack of sufficient clinical learning material, experienced clinical nursing faculty, and poorly equipped nursing skill labs. Nursing regulatory bodies must regularly monitor and ensure that deficiencies are rectified and nursing faculty remain clinically updated and active to produce clinically competent nurses.