Capabilities Toward Intravenous Patient-Controlled Analgesia: A Cross-Sectional Study of Registered Nurses Working in Two Tertiary Hospitals in China and Thailand.

BACKGROUND: An increased interest has been observed in the wide use of intravenous patient-controlled analgesia (IV-PCA) to control acute postoperative pain in both China and Thailand. The safety and efficacy of IV-PCA in patient care requires competent and capable staff nurses. This study aimed to appraise the capabilities of Thai and Chinese registered nurses regarding IV-PCA as a guide to develop educational programs. METHOD: A descriptive cross-sectional survey was conducted with 203 Chinese and 270 Thai registered nurses. An anonymous self-report questionnaire addressing 6 domains of capabilities toward IV-PCA was used to collect the data. Descriptive and inferential statistics were employed to analyze the data. RESULTS: The study found that the mean percentage scores (MPS) of the overall capability on IV-PCA of the Thai and Chinese nurse participants were 55.5 (mean [M] = 57.3, standard deviation [SD] = 4.9) and 62.6 (M = 58.7, SD = 13.0), respectively, which indicated very low and low levels. Barriers to the use and care of patients receiving IV-PCA after surgery according to the Thai and Chinese nurse participants included a lack of knowledge and systematic training regarding IV-PCA and a lack of first-hand experience in providing care for IV-PCA patients. CONCLUSION: The study results call for intensive and effective training and education concerning all domains for registered nurses involved with patients receiving IV-PCA.

The Effectiveness of an Evidence-Based Pain Management Program on Pain Intensity and Chest Rehabilitation Improvement Among Chest Trauma Patients in a Thai Hospital.

BACKGROUND: Pain after thoracic injury has further profound impacts on patients resulting in increased length of hospital stay and hospital care cost, and decreased quality of life. Utilization of the cutting-edge evidence on pain management that fits with the individual care context is therefore important. AIM: To examine the effects of an evidenced-based pain management program on the worst pain intensity and lung vital capacity among acutely ill hospitalized chest trauma patients. DESIGN: A two-group repeated measures design. SETTINGS: trauma unit, a university hospital in southern Thailand. PARTICIPANTS/SUBJECTS: 42 chest trauma patients. METHODS: The study population included 42 chest trauma patients admitted to the trauma unit. Twenty-one eligible chest trauma patients were consecutively assigned into intervention and control groups. The impacts of the intervention on the level of the worst pain intensity and lung vital capacity were measured before implementation of the program and throughout the first 5 days of admission. RESULTS: The study found a significant reduction in the worst pain intensity and an increase in the lung vital capacity among chest trauma patients in the intervention group compared with the control group (p < .05). CONCLUSIONS: Use of a pain management program can be an effective, inexpensive, and low-risk intervention for the improvement of pain management and chest rehabilitation among chest trauma patients.

Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study.

BACKGROUND: One of many types of injuries following an earthquake is spinal cord injury (SCI) which is a life-long medically complex injury and high-cost health problem. Despite several negative consequences, some persons with SCI are resilient enough to achieve positive adjustment, greater acceptance, and better quality of life. Since resilience is influenced by several factors and can vary by context, it is beneficial to explore factors that affect the resilience of people who sustained spinal cord injury from the 2015 earthquake in Nepal. METHODS: A descriptive cross-sectional study included 82 participants from the Spinal Injury Rehabilitation Center and communities in Nepal. Participants completed the Demographic and Injury-related Questionnaire, Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, Moorong Self-efficacy Scale, Intrinsic Spirituality Scale, and Patient Health Questionnaire-9. Pearson's correlation and point biserial correlation analyses were performed to examine associations between resilience and independent variables. A hierarchical regression analysis was used to identify the influence of certain factors. RESULTS: Findings indicated significant associations between resilience and social support (r = 0.42, p < 0.001), self-efficacy (r = 0.53, p < 0.001), depressive mood (r = - 0.50, p < 0.001) and demographic variables which included sex (r = 0.47, p < 0.001), employment (r = 0.27, p = 0.016), and current living location (r = 0.24, p = 0.029). There was a non-significant association between resilience and spirituality (r = - 0.12, p > 0.05). In hierarchical regression analysis, an overall regression model explained 46% of the variance in resilience. Self-efficacy (ß = 0.28, p = 0.007) and depressive mood (ß = - 0.24, p = 0.016) significantly determined resilience after controlling the effect of demographic variables. Among the demographic factors, being male significantly explained the variance in resilience (ß = 0.31, p = 0.001). CONCLUSIONS: Multiple psychosocial and demographic factors were associated with resilience in people who sustained an earthquake-related SCI. Mental health professionals should demonstrate concern and consider such factors in allocating care in this group. Development of intervention research concerning resilience is recommended to strengthen resilience in order to improve rehabilitation outcomes and enhance reintegration of individuals with SCI into their communities.

Breast cancer awareness among Indonesian women at moderate-to-high risk.

In this descriptive cross-sectional study, we examined awareness of breast cancer among Indonesian women at moderate-to high-risk of developing breast cancer. Data were obtained from 87 eligible participants using the Modified Breast Cancer Awareness Measure. The International Breast Cancer Intervention Study model was used to identify women at moderate-to-high risk of developing breast cancer. The data were analyzed using descriptive statistics. The results showed that none of the participants had knowledge of age-related risk (0%). Other domains that indicated low awareness were knowledge of lifetime risk (31%), followed by knowledge of risk factors, in particular the item regarding menstruation at an early age (12.6%). These results indicated that increasing awareness of breast cancer risks is highly needed, in particular among women at moderate-to-high risk of developing breast cancer in Indonesia.

Persistent post-surgical pain and its relationship to health-related quality of life in Pakistani women after breast cancer surgery.

Background: Breast cancer is the most commonly diagnosed cancer in women; it is also the second-leading cause of death from cancer. Persistent pain after breast cancer surgery is a serious clinical problem that negatively impacts the health-related quality of life of breast cancer survivors. Although persistent post-surgical pain following breast cancer surgery has long been under-reported; however, it is less explored in Pakistan's geographical background. Objective: The study aimed to examine the persistent post-surgical pain after breast cancer surgery and its relationship to health-related quality of life among Pakistani women. Methods: A descriptive correlational research design was employed in this study. The Brief Pain Inventory Short Form (BPI-SF) was used to assess the persistent post-surgical pain. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was used to measure the health-related quality of life. Data were collected between February and May 2019 from Pakistani women who have undergone breast cancer surgery for at least three months and attended follow-up visits at two tertiary care hospitals in Pakistan. A Spearman's correlation coefficient was used for data analysis. Results: The study included 91 Pakistani women. The participants were all females, with an average age of 45.6 years (SD = 6.53). The majority received radical mastectomy (n = 84, 92.3%) with adjuvant therapy (n = 91, 100%). The prevalence of breast surgery-related persistent pain was 100%, with 63 (69.2%) rating the pain as moderate to severe and reported neuropathic pain. The data analysis revealed a statistically significant negative correlation between BPI-SF items and FACT-B dimensions (r = -.43, p < 0.01). The participants appeared to show the highest score of the FACT-B in the social/family well-being (M = 16.58, SD = 3.44). The lowest score of the FACT-B was physical well-being (M = 6.98, SD = 6.38). Conclusion: Persistent post-surgical pain has a negative impact on the health-related quality of life of Pakistani women breast cancer survivors, particularly on their physical well-being. Therefore, follow-up care of breast cancer survivors after treatment completion requires proper persistent pain-relief treatments and interventions to control pain and maintain health-related quality of life in oncology and research in this sphere. This basic knowledge from this study will enlighten the nurses and health care professionals to pay more attention to pain management and regular evaluation of persistent post-surgical pain after breast cancer surgery in order to improve their health-related quality of life.

The effect of a foot care camp on diabetic foot care knowledge and the behaviours of individuals with diabetes mellitus.

AIM: The aim of this study was to examine the effectiveness of a foot care (FC) camp to enhance diabetic foot care knowledge (DFCK) and diabetic foot care behaviours (DFCB) among diabetic participants in Indonesia. METHODS: A two-group pre- and post-test quasi-experimental design was used in this study. A total of 72 participants completed a 5-week programme. The participants' DFCK and DFCB were examined in the fifth week using the Modified Diabetic Foot Care Knowledge (MDFCK) and the Modified Diabetic Foot Care Behaviours (MDFCB) questionnaires. Data were analysed by descriptive and independent t-tests. RESULTS: The mean score of DFCK (DFCK and DFCB in this study represent the score of knowledge and behaviors which gathered from MDFCK and MDFCB's questionnaires) in the experimental group after completing the FC camp was significantly better than that in the control group (p < .001). Similarly, the mean score of DFCB in the experimental group after completing the FC camp was significantly better than that in the control group (p < .001). CONCLUSIONS: The FC camp was found to enhance DFCK and DFCB among diabetic patients. Therefore, this programme can be utilised for nursing practice in order to prevent diabetic foot ulcers and foot amputation.