DSpace Collection: College of Nursing

Nursing student’s Knowledge and application of pain assessment at King Saud University

Sat, 12 Jun 2010 00:00:00 GMT

Title: Nursing student’s Knowledge and application of pain assessment at King Saud University

Authors: Al-Motairy, Modi Owied; ElMorsy, Nagat

Abstract: Background and aim: Pain has been defined as the fifth vital sign due to itsimportance in nursing practice. Knowledge deficit and untoward attitude are majorcontributing factors in the under assessment of pain. The aim of this study was toexamine the level of theoretical and applied knowledge as well as the attituderegarding pain assessment among nursing students. Subjects and methods: Thestudy was carried out in Nursing College King Saud University, in the Kingdom ofSaudi Arabia, at the beginning of the first semester 1430/1431H (2009/2010), usingan exploratory descriptive design. The study sample included 119 nursing students inthe baccalaureate nursing program at the 5th to the 8th levels. Data were collectedthrough a self-administered questionnaire assessing theoretical and applied knowledgeand attitude towards pain assessment. Results: The response rate was 91.6%. Studentswere all females with age ranging between 19 and 27 years. Major deficiencies werefound in students' theoretical and applied knowledge, with only 7.3% of them havingtotal satisfactory knowledge, and 19.3% having positive attitude. Additionaleducational activities dealing with pain have negative effects on students' knowledge.Theoretical knowledge decreased with increasing educational levels, while attitudeincreased. GPA had a negative effect on applied knowledge, but a positive effect onattitude. Conclusion: It is concluded that nursing students in the Faculty of nursing atKSU have a major deficiency in their knowledge regarding assessment of pain. Thedeficiency is more marked in applied knowledge. Additionally, the majority of thestudents have negative attitudes towards pain assessment. The results consistent withother published research, and raise implications for nursing education, at theundergraduate level within nursing practice, and highlight areas for further research.Recommendations: Construct and implement several strategies to enhance studentunderstanding and application of relevant knowledge and practice by: a. Consideringthat pain is a serious problem; b. Pressing information about pain throughoutcurriculum; c. Developing an integrated approach to teach students about theexperiences of pain; d. Providing students with the opportunity to appreciate theperspectives of patients; e. Taking successive pain courses and implement reflective learning intervention.

Description: Masters

Leadership Behaviour as Perceived by Nursing Clinical Teachers and Their Students at College of Nursing, King Saud University

Sat, 29 May 2010 00:00:00 GMT

Title: Leadership Behaviour as Perceived by Nursing Clinical Teachers and Their Students at College of Nursing, King Saud University

Authors: Putri, Gusrina Komara; Salem, Olfat Atia; Baddar, Fatma Moustafa

Abstract: King Saud University is entering a period of change and challenge that will require strongleadership to be navigated successfully. In such context, examination of leadershipassessment is essential for the development of institution. Specifically, for nursingeducation, clinical teaching is an integral part with a significant role. Based on it,examination of clinical teachers' leadership behaviour is a pivotal element to increase thequality of clinical teaching. Leadership defines as a process of uses interpersonal skills toinfluence others to accomplish specific goals. Transformational and transactional was oneof the most recent and popular nursing leadership theories developed by James McGregorBurns (1978). This study aimed to assess the clinical teacher leadership behaviours asperceived by themselves and by their students at College of Nursing. In addition,relationship between the studied groups also addressed. Descriptive comparative designwas selected to be the framework for this study. The study conducted on 28 clinicalteachers represent all academic nursing education departments and 215 nursing studentsfrom level 4th – level 8th of academic semesters from those meetings the inclusion criteriaand were available during data collection period. Multifactor Leadership Questionnaire(MLQ) developed by Bass and Avolio (2005) was used to measure leadership behaviour interm of “self” (clinical teacher) and “observer” (nursing student). The results of the studyrevealed statistically significance difference between leadership behaviour perception ofclinical teacher and their students. Based on it, the researcher recommended regularfeedback for clinical teacher. In addition, training and development in leadership,specifically, for the transformational leadership is essential in increasing quality of clinicalteaching in college.

Description: Masters

Identification of Factors Associated with Postpartum Depression among Saudi Females in Riyadh City

Wed, 02 Jun 2010 00:00:00 GMT

Title: Identification of Factors Associated with Postpartum Depression among Saudi Females in Riyadh City

Authors: Al-Shami, Nesreen; El Atty Moawed, Salma Abd

Abstract: Postpartum depression is a serious medical condition experienced by women soon after giving birth. Up to 75% of new mothers experience the condition's mildest form, "baby blues" which may result from the rapid hormonal shifts that occur during postpartum period. These postpartum blues typically begin a few days after the baby's birth and generally resolve within two weeks. Tearfulness and depression mood are common features and are usually self-limiting. Women with "baby blues" often report feeling overwhelmed, anxious, irritable and sensitive.A more serious form of the disorder is referred to as postpartum depression. Post partum depression is a significantly more severe depressed mood than "baby blues" and often last much longer. It affects approximately 10% of post partum mothers and is characterized by sadness, frequent crying, insomnia, appetite change, difficulty concentration or making decisions, feeling of inadequacy, and lack of interest in normal activities. Postpartum depression most often occurs around the fourth week after givingbirth, just prior to resumption of menses, and after weaning; however, it may occur any time during the first postpartum year. Risk factors for postpartum depression include first birth, ambivalence about the pregnancy, lack of social support, economical problems, history of abortion, died infant, gender of infant, medical or surgical history, number of pregnancies, type of delivery, life stressor event, lack of partner, and a history of depression or another depression illness, and more.Study Objectives:The current study aims to:1- Analyze the risk factors contributing of PPD mothers in Saudi Arabia.2- Correlate between risk factors and postpartum depression. So it is of great value to conduct postpartum depression study , the most sensitive and unsearched well issue in our cutler and as health care providers in order to assess and investigate most important factors that affect post partum mothers in attempting their role in infant, family and self care. Result for instrument used were found as: The result obtained from sample socio-economical status factors and previous obstetrical history indicated strong relationship between postpartum depression and mothers in middle age group (37%), unemployed (54%), low education level and non professional (65%). History of disease were found to be non with (96%), family history of depression were non in most of the sample with (67%). History of previous postpartum depression were found in (64%) of sample and non of them were effected by any other psychological disease. Multi-Para (2-6 pregnancies) were found to be more effected by post partum depression (60.5%), as well as number of abortion (73%).Data related to last pregnancy indicated that 85% of them did not encounter any health problems during pregnancy and the remaining 14.5 were affected by anemia. Most of the mothers came across problems during last delivery (52%) with (75%) of the problem associated with difficulty of labor. Newborn were 55% not complaining of problems during last delivery. With normal birth weight 2200mg-2100mg (69.5%). Majority of mothers did not diagnosed by antenatal depression during last pregnancy (53.5%) and the rest who diagnosed by antenatal depression (46.5%) were most diagnosed at third trimester (23%). Type of last delivery indicated that cesarean section were more related to postpartum depression with 52.5% more than normal vaginal delivery, complications after delivery were found in 62.5% of mothers and the most common reason were breast inflammation and feeding problem . Father socioeconomic status studied in different country to show the relationship between father occupational, educational and family monthly income then by statistical method define the social level of family, the questioner help this study in identifying father relationship as essential factor in postpartum depression. Result indicted that 56.5% of father educational level were intermediate and primary, 78.0% were semi-profession or skilled worker and 51.5% of family monthly income were between 5000 to 7999. Final family social class shows that 82.0% of families were middle social class. Life stressor scale shows that all study sample 200(100%) have low stress event; this may indicate a critical issue that post partum depression can develop even in low life stress and it also can indicate that physiological changes and personality type of mothers can more affect in developing of postpartum depression than outside or environmentaland social factors. The scale divided to 10 items each items as discussed contain several points, 105 points in total. Item related to giving birth e.g. mode of delivery, infant status, becoming pregnant, husband desire to get pregnant, fertility issue, got the highest mean score (18.88) it indicate that women are more influenced by issues related to stress during pregnancy and delivery, followed by the scale attitude related to marriage e.g. enforced to get marred, relation with husband, separation from husband, with average mean (17.91), and then the scale of attitudes related to money e.g. Demand loan, not able to pay loan, with average mean (17.11). Signs and symptoms of depression mode were searched to identify most common indication for the disease. Mothers who thought that they ' don¡¦t feel happy' got highest mean score (4.44). Mean of (4.01) for both feeling of 'interrupted sleep either few or much sleeping' and mothers feel that' husband did not honored or respect them'. Mothers who feel anxious and can not relax got mean score of (3.94). But no suicide or die thought were found in this sample. Other signs of postpartum depression were found with less mean e.g. perform all things slowly, future may be desperate, feeling guilt and deserve penalty, cant take decision, may not concern with important things, feel tired, feeling of emptiness, others like "am sure my husband mother did not love me ", "I feel my husband is punishing me because I get pregnant and deliver without his desire", "I have no concern with my child", were added to address our cultural concerns. Based on the study findings the following recommendations are suggested in providing care and preventing from postpartum depression in kingdom of Saudi Arabia:For Research: More research is n needed to: „h Assess life style / stress / environmental factors around family that can lead to postpartum depression. „h family awareness and practice which may predisposed or influenced women depression „h Health education program by maternity nurse or/and psychologist about physical and psychological changes during pregnancy are needed for women pre-conception , during pregnancy and during postnatal period . „h Provide books, websites, and phone discussion if needed . „h Continuing in-service training program for all nurses working in maternity departments and primary health care centers to enhance their awareness about different type of stressor in life which has effect on reproductive health and how family and mother can manage Community and Family: „h Group of home health care nurses, psychologist and social workers should visit mother at risk to assess , prevent and follow up her situation, and helping affected mother family / father to cope with disease. Observe for father and family adjustment and provide social and psychological support.It is important to replicate the study in other regions with different sample and in different culture group within the kingdom in order to generalize the result to other groups

Description: Masters

Impact of breast feeding on Females' body image

Sat, 27 Jun 2009 00:00:00 GMT

Title: Impact of breast feeding on Females' body image

Authors: Al-Mutairi, MaryamAbdulrahman; Fayad, Elham

Abstract: Breastfeeding is a natural process but it does not alwayscome without a learning curve for many mothers. It is rare thatmothers do not have any difficulties breastfeeding. The key is tostick with it, get support and guidance from a lactationconsultant and be careful to not introduce bottles or formulaunless you have tried everything else first.The World Health Organization (WHO) recommends that allinfants be exclusively breastfed from birth to 6 months of age,followed by the gradual introduction of other forms of nutritionand continued breastfeeding into the second year and beyond.Body image can basically be defined as the mind's pictureof the personal body and accompanying thoughts, feelings, andperceptions.In relation to breastfeeding, body image disturbance traitsmay influence a woman's initial decision to breastfeed, as wellas possibly promote discomfort within the breastfeedingrelationship, causing early cessation.Aim of the study:-The aim of this study was to assess impact of breast feedingconcept on mothers' body image and initiation and continuity ofbreast feeding in Riyadh city.The study was conducted at (antenatal clinic & well babyclinic) Primary Health Care Centers at East & West Riyadh city.A systematic random sample used to choose these centers. Thefive regions of Riyadh city were subjected to equal chance inorder to select two regions out of five (East & west) regionswere randomly elicited. Form the two regions also centers wererandomly selected from each two regions out of regions. Hencethe four centers were selected for data collection were PHCcenters (Al-Soli & East Nasseim ) East region, PHC centers(Erijah C & Badiah ) West region.A total population of this study 200 woman, including 100pregnant women who at the third trimester of their pregnancyand 100 women who are breast fed their infants at the first 3months of their life. A convenient sample technique was usedfor selecting participants. At each four clinics 25 pregnantwomen from ante natal clinics & 25 lactating woman wereselected with the following Inclusive criteria.Inclusive criteria for selection of the population subjects was asfollows:1- Mothers age from 18-30 years.2- Mothers either first pregnancy or with maximum 3children.3- Mothers who has normal physical condition withoutchronic illness.4- Non-Saudi mothers were excluded from the sample.5- Mothers who are willing to participate in this study.A pilot study was conducted on 10 women to test the validityand reliability of the tools and to estimate the time required forfilling the sheets and to establish the research modificationprocedures. Any required modification was done.Data was collected from the period of (Rajab , 1429 / July,2008) to Duo-Quad a, 1429 / December 2008) for duration ofsix months.A structured questionnaire composed of two parts was utilizedto collect the required data;I - Structured interviewing questionnaire was constructed by theresearcher after consulting the experts in maternity &pioneers health care field, the questionnaire consists of twoparts:ÞFirst part of the questionnaire included:A. Socio-demographic data such as (age, educational level,occupation status, income/ month, etc…).B. Obstetrical History such as ( Number Previouspregnancies &months, Number of live children & Type ofdelivery, etc. )Þ Second part of the interview was aimed at assessing theFactor that encouraging and hindering initiation of breastfeeding ,twenty-nine questions was developed by theresearcher review of literature, it was formed as Likertscale answers ranging from strongly accept (4 grades) tostrongly not accept (1 grade)II - The Body Image Disturbance Scale ( Al- Dousky, 2004). Itis a 34 likert-scale (5 answers) ranging from always (4grades) to never (0 grade) with maximum total score 136and minimum score 34. The highest scores indicates thatwoman is satisfied with her body image while lowestscores indicates that woman is not satisfied with her bodyimage. Total scores of Body Image Disturbance Scale wasdivided as follows:1- > 50 scores is totally not satisfied with body image.2- 50 >100 scores moderately satisfied with her body image.3- Above 100 scores is totally satisfied with her body image.The results of the study revealed that:-1. Near half and above two thirds the pregnant and lactatingmothers aged (25 > 30 years ) (51% & 67%) respectively.Concerning educational level of the studied samples, thatmore than half of the pregnant mothers (59%) and (48%)of the lactating mothers had secondary school education.2. Most of the pregnant and lactating mothers are working(81% & 73%), among who had rented house were (55% &57%) and of the population who had a present of made(75% & 67%) respectively. And above two-third of thepregnant and lactating mothers (65% & 63%) belonged tolow and moderate socio-economic level.3. Wither the of pregnant and lactating mothers (21% &38%) initiate breast feeding at the second day afterdelivery respectively, as regards the previous breastfeeding duration takes a period of three months afterdelivery (34% & 73%) respectively for present pregnantmothers.4. There is a statistically significant relationship betweenfactors that encourage /hinder initiating & continuity ofbreast feeding among both studied sample (p = < 0.001).In relation to total scores of body image between pregnantand lactating mothers, a statistically significant relationwas found (p = 0.01).5. The lactating mothers are more active in initiating breastfeeding than the pregnant mothers during, days of thenewborn’s age (37% & 32% ) (23% & 16%) respectively,but (there was no significant difference between the twogroups regarding the time of initiation of breast feeding.6. The percent (70% & 40%) wither the lactating andpregnant mothers were continues breast feeding theirinfants for the first three months of their infants’ agerespectively ,while the minority (2% & 37%) were notlactating their infants and still pregnant for the first time.There is a significant relationship in relation to continuityof breast feeding among lactating mothers (p = 0.001).7. A considerable percent of the pregnant and lactatingmothers (74% & 77% ) considered that colostrums in thefirst three days after delivery is important for the newbornwhile (37% & 35%) of both groups accept and stronglyaccept that bottle feeding is better than breast feedingbecause it helps infant to grow healthy respectively.8. The two-third of the pregnant (61%) and near half (54%)lactating mothers & did not take the decision to breastfeed their infant during their pregnancy respectively.9. The (41% ) of the pregnant and (50%) of the lactatingmothers, regarding who is responsible to decide to breastfeed the new coming body; both groups strongly notaccept that they are only the one who is responsible to takethe decision of breast feeding. In relation to feeling ofhappiness during breast feeding among pregnant andlactating mothers (36%& 83%) strongly accept andstrongly not accept respectively.10. Near two third of the pregnant (59%) and (43%) lactatingmothers were strongly not accept the fact that breastfeeding will protects the mothers from having breastcancer or protect their body from having gastroenteritisrespectively.11. (44%) of the pregnant mothers accept the idea that theirwork interfering with their readiness to breast feed theirbabies, while (30%) of lactating mothers not accept thesame proposed idea. .12. Among the pregnant (45%) and with lactating mothers(48%) accept that breast feeding sessions are given onlytwo times per day and continue with artificial feeding Inrelation to the importance of breast feeding, (37%) of thepregnant mothers accept that breast feeding is importantonly for the first three months of the kids age and thenthey can stop it , while (34%) of lactating mothers are notaccepting this idea.13. Occupation of lactating mothers is significant to thefactors hindering breast feeding (p= 0.000) and is notsignificant in relation to factors hindering breast feedingand body image among pregnant mothers (Mean = 74.4& SD = 7.04) (Mean = 95.05 & SD = 15.4) respectively.14. The presence of made in the house pregnant and lactatingmothers is not significant to their factors hindering breastfeeding and their body image (Mean = 74.7 & SD = 6.6)(Mean = 97.5 & SD = 13.4) (pregnant mothers ) and(Mean = 80.3 & SD = 10.8 ) (Mean = 94.2 & SD = 11.2)(lactating mothers )respectively.Conclusion:The results of this study folded that regardless of the personalhindering or encouraging initiation factors characteristics apositive body image was proved to be relatively high amonglactating mothers regardless initiating or hindering factors orknowledge that positively encourage breast feeding.Recommendation:1. Integrating self-efficacyMaternal breastfeeding self-efficacy is a significantpredictor of breastfeeding duration and level. Integratingself-efficacy enhancing strategies may improve the qualityof healthcare that healthcare professionals deliver & mayincrease a new mother's confidence in her ability tobreastfeed, & to persevere if she dose encounterdifficulties.2. Address mothers' self confidenceThe individual mother is responsible for the success ofbreastfeeding and the discourses are hiding that generalperceptions of breastfeeding undermines the mothers'confidence in breastfeeding should be addressed.3. Dissemination of information and educationThe study suggests a need for dissemination ofinformation and education regarding optimal breastfeedingpractices and for protecting and promoting healthytraditional practices.4. Involvement of pregnant and lactating mothers, invarious activitiesInvolvement of pregnant and lactating mothers, in variousactivities is desirable as they all have an important role ininitiation of breast-feeding and other healthy feedingpractices at the community level.5. Promoting institutional deliveriesThey should be made aware of advantages andpsychological implications of optimal breast-feedingpractices. Efforts should also be made for promotinginstitutional deliveries for providing them betteropportunities of health education for early initiation ofbreast-feeding.6. Conduct researchConduct research that identifies the social, cultural,economic, and psychological factors that influence infantfeeding behaviors.7. Educational programsWhile the educational programs launched to convey thebenefits of breastfeeding often focus on the health of thebaby, the focus needs to shift to the decision-makingprocess that mothers go through in making infant feedingchoices, including the effect of body image onbreastfeeding initiation and duration.8. Promoting & improvement mothers need informationBefore any increases in breastfeeding rates can occur, trueunderlying causes of breastfeeding practices, as well asbarriers to breastfeeding initiation, must be identified andaddressed to best meet the needs of mothers and to bestprovide for the health of future generations.9. Family and peer supportA universal service for initiation of breast feeding usingpeer support and family assistance provided withinantenatal clinics is required.10.Outreach servicesA policy for attending breastfeeding sessions duringantenatal period is a must for all pregnant mothersespecially during the third pregnancy trimester andespecially for those living in relatively deprived areas andinitiation and implementation of home visits forpostpartum women to assess and encourage women tocontinue breast feeding is necessary.11.Paid maternity vacationCommunity health team should encourages and advocateswomen to have postpartum maternity leave with full salaryfor the first 6 months of the child's age for exclusivelactation and flexibility in working conditions forbreastfeeding women.12. The role of healthcare providersThe healthcare providers must focuses on the benefits ofbreastfed versus formula-fed infants across time andNurses & Pediatricians have significant role in initiationand support mothers to start breastfeeding earlyespecially if the hospital rules is to keep woman whodelivered normally for at least 12 hours post delivery.

Description: Masters