International Journal of Practical Nursing

 An implantable cardioverted defibrillator or automated implantable cardioverted defibrillator is a device implantable inside the body, able to perform cardioversion, defibrillation and pacing of the heart. The device is therefore capable of correcting most life threatening cardiac arrhythmias. The ICD is the first line treatment and prophylactic therapy for patients at risk for sudden cardiac death due to ventricularfibrillation and ventricular tachycardia. Current devices can be programmed to detect abnormal heart rhythms and deliver therapy via programmable antitachycardia pacing in addition to low­energy and high­energy shocks.

Keywords: Implantable Cardioverted Defibrillator; Ventricular Fibrillation; Ventricular Tachycardia.

  Over the last two decades tremendous advances have been made in the health science. These advances have principally been used to help clinicians. Clinical decisions are now based on information derived from research. This practice is called evidence based practice. The movement towards evidence health based practice requires that educators and practitioners engage in collaboration research. Hence the author is interested in the formation of partnership between academic institutions and health care institutions provides opportunity for research and to improve practice. Such endeavors offer exciting opportunities for educators to work with the evidence base for quality nursing interventions. 

Keywords: Evidence Based Practice; Research Findings; Cost Effective Care; Best Patient Outcome.

  Migraine can be regarded as a highly prevalent chronic neurological condition with episodic exacerbations and is related with significant pain, disability. It also reduces the quality of life. The exact cause of migraine is not fully implicit.Migraine attacks also seem to result from pathophysiological mechanisms activated by specific triggering factors. Thus, management of migraine is an important healthcare issue. Migraine management includes avoidance of trigger factors, lifestyle modifications, non­pharmacological therapies, and medications. This paper reviews about the impact of some trigger factors and lifestyle modifications on migraine.

Keywords: Migraine; Lifestyle Modifications; Trigger Factors.

 Nutritional experts have referred to breakfast as the most important meal of the day; citing studies find that people who skip breakfast are disproportionately likely to have problems with concentration, metabolism, and weight. The survey approach was selected since the study was designed to explore breakfast skipping tendency and to analyze the memory. By doing research on about 70 samples, the investigator could understand the depth of the problem.

Keywords: Nutrition; Metabolism; Metamorphosis.

 Rehabilitation which is major technique for a victim to restore the lifestyle functions as possible utilize for daily activities. The patients with stroke are in need of rehabilitation. The stroke rehabilitation can start at the right time will helpful patients with stroke can do best possibilities as early as possible without dependence.

Keywords: Stroke; Rehabilitation; Rehabilitation Team; Rehabilitation Nurse.

CBR is aimed at improving the quality of life of people with disability. It is a multi­sectoral strategy that empower person with disability to assess and benefit from education, employment, health and social services. 

Keywords: Rehabilitation; Disability; Quality of Life; Multi­Sectoral Strategy; Community Awareness Counseling; Self Actualization; Communication.

 Objective: To explore the relationship between coping strategies and emotional distress of breast cancer patients and their care takers. Methodology: The present study was descriptive correlational study. The data was collected from SVIMS radiation oncology unit in Tirupati during December 2015 to feb 2016. There were 60 participants including 30 breast cancer patients and 30 their care takers. The study sample comprises of breast cancer patients with inclusion criteria I, II and III stages of breast cancer who are attending to radiation oncology unit aged between 30­65 yrs, were selected and their care takers were also included in the study. Sample was selected by purposive sampling technique. Brief cope scale (carver 1991) and the distress thermometer with accompaing problem list were used for data collection. The data was interpreted through SPSS ­20. Results: The study results revealed that 6 most frequently used coping strategies of patients with breast cancer were religion , use of instrumental support, use of emotional support, acceptance, positive reframing, planning where as 4 most frequently used coping strategies by care takers were positive reframing, planning, active coping, acceptance. Emotional distress of breast cancer patients and care takers results revealed that the total mean scores of breast cancer patients distress was 21.10(SD­ 5.874) and their caretakers mean distress was 18.90(SD­ 6.955). The results showed that patients had more emotional distress than their care takers. Coping strategies of patients with breast cancer namely acceptance, self distraction, active coping, positive reframing, venting, religion, humor, planning were related to their emotional distress.( r=0.629, p<0.01, r=.588, p<0.01, r=.584 p<0.01, r=.538,p=<0.01,r= .427,p<0.05, r=0.413, p<0.05,r=0.403 p= <0.05, r=.385, p<0.05,).coping strategies of care takers of breast cancer patients namely active coping, positive reframing, venting, acceptance were related to their emotional distress(r=0.623, p<0.01, r=0.601, p<0.01, r=0.497, p<0.01, r=0.442, p<0.05). Conclusion: he findings support the notion that some coping strategies are related to emotional distress both in breast cancer patients as well as their care takers. 

Keywords: Breast cancer; Emotional distress.

 The Partograph, a graphic recording of progress of labour and salient conditions of the mother and fetus. The partograph serves as an “early warning system” and assists in early decision on transfer, augmentation and termination of labour. Quasi experimental study was conducted to evaluate the effectiveness of planned teaching programme on partograph to assess and compare the knowledge and practice of staff nurses in experimental and control group, to determine the relationship between the knowledge and practice of staff nurses regarding partograph before and after the administration of planned teaching programme & to determine the association of level of knowledge and practice of staff nurses regarding partograph with selected variables. The design was pre­test post­test control group. Sixty staff nurses, 30 in experimental group and 30 in control group were selected by convenient sampling technique. Staff nurses from MMIMS&R Hospital Mullana, Ambala & Civil Hospital Ambala City were selected. Structured knowledge questionnaire and structured simulation situations were used to generate the required data. The mean post test knowledge score (23.73+ 2.95) and mean post test practice score (54.53+3.89) in experimental group were higher. than control group and were found statistically significant at 0.05 level of significance. A moderate positive correlation (0.231) was found between knowledge and practice score of staff nurses. There was significant association between gain in knowledge score of staff nurses and their previous education. Study concluded that planned teaching programme was effective in enhancing knowledge and improving the practice of staff nurses regarding partograph. 

Keywords: Pregnancy; Augmentation; Partograph.

 Diabetic foot is often quiet a dreaded disability, with long stretches of hospitalization, and impossible mounting expenses, with ever dangling end result of an amputated limb. Citric acid treatment of chronic infected wounds offers excellent results. A Quantitative true experimental study was conducted in SVMCH & RC Hospital with 40 diabetic foot ulcer samples. 20 in experimental and 20 in control group are chosen by simple random sampling technique. Pre test and post test was conducted in both groups. Citric acid dressing was provided to experimental group for I week. The post test mean and SD of experimental group was 15.40±3.12 with ‘t’ value of 5.493 which was significant at p<0.001 level. It was proven that the citric acid dressing is effective for diabetic foot ulcer patients. 

Keywords: Diabetes Foot Ulcer; Citric Acid Dressing; Wound Healing.

 Background: Epilepsy is one of the oldest diseases known to human beings.Epilepsy is a common major neurological problem in developing countries including India. India has the second largest population in the world with almost one billion plus inhabitants and 70 to 80% of people live in rural communities. The single incidence study from southern India, has documented a rate of 49.3 per1,00,000 and the global incidence varies from 11 to 190 per 1,00,000 population. WHO (2015 may) estimated that there are over 50 million epileptic sufferers in the world today, globally 2.5million of them live in developing countries and 2.4 million new cases of epilepsy occur each year globally. Objectives: 1.To assess the knowledge regarding home care management of epilepsy among care givers by pre test. 2.) To evaluate the effectiveness of structured teaching programme on knowledge regarding home care management of epilepsy among care givers. 3.) To associate the post test knowledge on home care management of epilepsy with caregivers selected socio demographic variables. Methods: A pre­experimental one group pre­test and post­test design was adopted involving 50 caregivers of patients with epilepsy was carried out with interview schedule. Data was collected by using a structured questionnaire. Data regarding socio­demographic characteristics and checklist related to home care management of epilepsy. Data were analyzed with Frequency and percentage distribution, Mean and standard deviation and Chi­square test. Results: In pre­test among 50 caregivers of patients with epilepsy, 24(48%) were having moderate knowledge, 19(38%) were having inadequate knowledge and only 7(14%) having adequate knowledge. In post­test 28(56%) were having adequate knowledge, 22(44%) were having moderate knowledge, none of the clients were having inadequate knowledge. H1 was accepted. Conclusion: The present study revealed that epilepsy patient caregivers have inadequate knowledge regarding homecare management of epilepsy before STP and after STP knowledge had improved among caregivers. 

Keywords: Epilepsy; Home Care Management; Care Givers; Knowledge. 

 Purpose: To assess the effectiveness of digital pressure on pain among patients receiving intramuscular injection in selected hospitals of Pune city, india. Objectives: To assess the intensity of pain in patients receiving digital pressure during and after giving intramuscular injection in experimental group, to assess the intensity of pain in patients not receiving digital pressure during and after giving intramuscular injection in control group, to compare the intensity of pain in patients receiving digital pressure and in patients not receiving digital pressure, during and after giving intramuscular injection, to find association of demographic variables with the intensity of pain. Methods: This was a quantitative quasi experimental research study of 60 patients (30 experimental group and 30 control group), who are receiving intramuscular injection on deltoid or gluteus muscle of selected hospitals of Pune during data collection period . The assessment of the intensity of pain were done in patient receiving digital pressure during and after giving intramuscular injection in experimental group by using numerical pain rating scale, visual analogue scale and behavioural responses. Then assessment of the intensity of pain done in patients during and after giving intramuscular injection in control group. Result: The mean scores in numerical rating scale during IM injection was 1.9 in experimental group and 3.5 in control group with t calculated value of 9.331816 for t table 2.048407 at a p value of “0” (p<0.01)which indicates that there was less pain in the experimental group during IM injection. The mean scores in visual analogue scale during IM injection was 1.16 in experimental group and 2.43 in control group with t calculated value of 9.641648 for table 2.048407 at a p value of “0” (p<0.01)which indicates that there was less pain in the experimental group during IM injection. The mean scores in numerical rating scale after IM injection was 0.9 in experimental group and 2.2 in control group with t calculated value of 14.3839 for t table 2.048407 at a p value of “0” (p<0.01)which indicates that there was less pain in the experimental group. The mean scores in visual analogue scale after IM injection was 0.8 in experimental group and 1.9 in control group with t calculated value of 10.70661 for t table 2.048407 at a p value of “0” (p<0.01)which indicates that there was less pain in the experimental group. Conclusion:Hence the findings signify that digital pressure was effective in reducing pain during and after intramuscular injection and can be implemented in clinical setting 

Keywords: Digital Pressure; Patients; Pain; Intramuscular Injection.

 Objective: To explore the relationship of quality of life and depression in type 2 diabetic patients in comparison with healthy individuals (controls). Methodology: The present study was case control study. The data was collected from SVIMS Hospital in Tirupati, during DEC 2016 to JAN 2016. There were 80 participants including 40 type 2 DM patients whilst for a comparative assessment a group of 40 healthy individuals (age and sex matched) were also selected as a controls to meet the purpose of the study. subjects age range was set between 35­65 years. The study sample comprised of type 2 DM patients. While inclusion criteria the type 2 DM patients with duration of 5 years and above attending OPD, were selected as a cases and healthy individuals were selected as a controls. Sample was selected by simple random sampling technique using random number generated in Ms excel. WHO quality of life scale (QOL BREF) by Frisch 1994 and Beck depression inventory (BDI­II) developed by Aeron Beck in 1996 were used for data collection . The data was interpreted through SPSS­20. Results: The study findings showed a significant but negative between quality of life and depression scores. Good quality of life was negatively correlated in comparison to the depression in diabetic patients(r=0.567++ <.01). It was also discovered that there were significant differences present in depression and quality of life scores of diabetic people and healthy individuals. It was also indentified that there was significant difference among educational status, occupational status and type of diet, marital status, living status , monthly income with respect to mean scores of QOL at p­<0.05 level and there were significant difference among education status, occupational status and type of diet with respect to mean scores of depression at , 0.05 level. conclusion: Higher depression scores in BDI scores and lower scores of quality of life scores were seen in majority of the type 2 DM patients during the study. 

Keywords: Diabetes Mellitus (DM); Type 1 Diabetes Mellitus ; Type 2 Diabetes Mellitus.

 Background and Objectives: Patients with psychosis are more sensitive and more susceptible to the effects of even minor life stressors. The stressful life events and coping strategies among patients with psychosis are examined, with an objective to determine it as a risk factor for relapse in psychosis. Materials and Methods: Patients who are diagnosed with psychosis as per ICD­10 criteria have been included. A case control study design has been adopted to investigate the stressful life events and coping strategies among patients with relapse and without relapse. Convenience sampling technique is used to select 30 patients with psychosis, among which 15 subjects were in the relapse group and 15 subjects were in the non­relapse group. Results: The study results shown that in relapse group, 60% of subjects had more stressful life events and 40% had less stressful life events. In nonrelapse group, 73.3% of subjects had less stressful life events and only 26.7% had more stressful life events. Besides, it was also found that presumptive stressful life events is co­related with the coping strategies in the relapse group (p<0.05) and there was no co­relation between these two in the non­relapse group. Conclusion: tressful life events in patients with psychosis remained as one of a major risk factor for relapse. Adequate coping strategies among patients with relapse are essential in order to achieve a speedy recovery from the illness. 

Keywords: Stressful Life Events; Coping Strategies; Psychosis; Relapse.