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   Table of Contents - Current issue
July-December 2022
Volume 19 | Issue 2
Page Nos. 97-182

Online since Tuesday, December 27, 2022

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Greetings from ISPN p. 97
Sandhya Gupta
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Fear of childbirth and its contributing factor – An exploratory study at a tertiary care hospital p. 98
Kanchan Sharma, Himanshu Vyas, Meenakshi Gothwal, Gomathi Arumugam
Background: Motherhood and pregnancy are cherished moments in a life and considered one of the most important events in a women's life. So, she does the best to maintain good health to bring into this world a healthy baby. The fear of pregnancy is called tocophobia and it is defined as an intense state of anxiety which leads to fear of childbirth. Fear of childbirth result in increased number of visits to the obstetrician and in frequent request for cesarean delivery. The study aimed to assess the fear of childbirth and factors contributing to fear of childbirth among primigravidae at a tertiary care teaching hospital. Methodology: Descriptive design with Quantitative approach was used and a sample of 269 primigravidae women by using consecutive sampling. Data was collected at Antenatal OPD, by using standardized tool Wijma delivery expectancy questionnaire Version – A and a checklist for factors contributing to fear of childbirth. Results: Level of fear of childbirth among primigravidae (24.4%) having severe level, (44.8%) high level and 24.1% having moderate level, 6.7% low level of fear of childbirth. Major contributing factor for fear of childbirth was Fear of labor pain (80.7%), and least common was disturbed self image and feeling of insecurity (27.9%). Conclusion: Majority of the primigravidae women face fear of childbirth, as contributed by various factors that affect fear of childbirth. Primigravidae women were counseled on one to one basis and they were made aware about the physiology of labor and what to expect during labor to alleviate their fear after the completion of the data collection process.
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COVID-19-related anxiety and coping strategies among nursing professionals working in COVID intensive care unit: A Cross-sectional survey p. 104
Mamta Choudhary, L Gopichandran, KP Jyotishana
Background: During the COVID-19 pandemic, nursing professionals along with other health-care workers worked as the pillars of the health-care system. There have been difficult times when nursing professionals have overworked despite shortage of resources, continuously wearing PPE over hours, and overfilled intensive care units (ICUs). Thus, while confronting the numerous COVID-19-related challenges, nursing professionals might have experienced anxiety and utilized various coping strategies to reduce their anxiety. Methods: The cross-sectional survey was conducted using a web-based questionnaire. Information was collected from 200 nursing personnel's working in the COVID ICU of a selected tertiary care hospital. The questionnaire used for data collection comprised three sections: the first section focused on sociodemographic profile of subjects, the second section included the Self-Rating Anxiety Scale, and the third included Brief COPE. Results: The result revealed that majority, 61%, of the subjects had no COVID-19-related anxiety, whereas 33.5% of subjects had mild-to-moderate COVID-19-related anxiety. However, only 5.5% of the subject reported marked-to-severe form of COVID-19-related anxiety. The highest anxiety scores were identified for items: (1) I get feelings of numbness and tingling in my fingers and toes, (2) I feel weak and get tired easily, and (3) I have nightmares. To cope up with anxiety, majority of nursing professionals' approach “praying or meditating” coping style mechanism followed by positive reframing and planning. Conclusions: COVID-19 is causing mild-to-moderate anxiety in a significant number of nursing professionals. Thus, the hospital administration and nurse managers should focus on early screening for anxiety, providing psychological support to nurses, and training ineffective coping strategies.
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Relationship between emotionally unstable personality disorder and remembered parenting style - A pilot study from private tertiary care center p. 109
Prerna Srivastava, Kannappa V Shetty, Jagadish Anjanappa
Introduction: Emotionally unstable personality disorder (EUPD) is a type of personality disorder which is characterized by symptoms, such as highly volatile mood, high impulsivity, unstable relationships, and self-harming behavior. Studies indicate that an individual's personality is an outcome of various factors, their parental upbringing being one of the major factors. Materials and Methods: The study aimed at exploring remembered parental style in patients diagnosed with EUPD. Ten patients were recruited from a tertiary care psychiatric hospital, and parental bonding instrument and clinical global impressions scale were administered. Results: The mean age of the patients with EUPD was 28.8 ± 7.77 years, and the mean years of education was found to be 15.4 ± 1.66. Mean age of onset of illness was 23.71 years, and the mean severity score was found to be 4.8. The mean mother's care score was found to be 25.6 ± 7.17 and mother's overprotection score was found to be 11.2 ± 5.53. The mean father's care score was found to be 20 ± 11.28 and father's overprotection score was 12.1 ± 6.38. Conclusions: The study findings reveal involvement of authoritarian parenting style in fathers and neglectful parenting style in mothers in the development of EUPD. However, a more comprehensive study with larger sample size is needed to throw more light over this finding.
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Attitude of nursing students toward people living with mental disorder p. 112
Kinley Gyaltshen, Dawa Gyeltshen, Nima Dorji, Kuenzang Kuenzang, Nguldup Gyeltshen
Background: Stigma held by health-care professionals toward people with mental illness can have serious negative impact on the quality of care provided by them. It is essential to adequately train the nursing students to develop favorable attitudes toward mental illness. In Bhutan, the level of stigma among student nurses remains understudied. Objective: The objective of this study is to investigate the attitudes of student nurses toward people with mental illness. Methods: It was a cross-sectional survey. A total population sampling technique was used. Two hundred and thirty-six student nurses completed a 40-item Community Attitudes toward Mentally Ill (CAMI) questionnaire to determine whether people with mental illness were viewed as “inferior;” deserving “sympathy;” perceived as a “threat” to the society or “acceptable” in the community. Independent t-tests and the analysis of variance were performed to determine the association of categorical variables with the CAMI. Results: Nursing students had favorable attitudes toward people with mental illness. The mean scores for the authoritarian (27.56 ± 3.95), benevolence (39.33 ± 3.71), social restrictiveness (21.51 ± 4.54), and community mental health ideology (37.29 ± 4.85) subscales reflected a positive attitude of student nurses. There was significant difference (F = 4.79, P < 0.01) only in the dimension of authoritarianism when CAMI subscales were compared according to the level (year) of the course. Conclusion: The study confirmed positive attitudes of student nurses toward people with mental illness. However, no significant difference in attitudes of student nurses according their level (year) of study underscores the need for revisiting current psychiatric curriculum and calls for further studies in the area.
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Exploring burnout in clinical psychologists: Role of personality, empathy, countertransference and compassion fatigue p. 117
Bidisha Bhattacharyya, Ushri Banerjee
Objective: Clinical psychologists, as professionals, come across various people and their problems frequently. Regular exposure to information which are distressing, stressful, and sometimes traumatic can create health issues and burnout, which is a psychological syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment, in them. A number of psychological variables can contribute to the burnout of clinical psychologists. The ones taken in this study are personality, empathy, countertransference (CT) and compassion fatigue. The study had been conceptualized to find the relation and contribution of the mentioned variables on burnout of clinical psychologists. Methods: Fifty one clinical psychologists participated in the study. Maslach Burnout Inventory, NEO Five-Factor Inventory, Questionnaire of Cognitive and Affective Empathy, Assessment of CT Scale and Compassion fatigue (CF), and satisfaction self-test for helpers were used for assessing the constructs. Relevant statistical analysis were performed. Results: Findings show that there are significant correlations between personality variables, i.e., neuroticism, agreeableness, and conscientiousness with other variables, i.e., compassion fatigue, empathy, and CT. Some of the personality variables are correlated to burnout. Empathy, CT, and CF contribute significantly to burnout. Conclusion: The study shows the probable indicators which can cause burnout in clinical psychologists, and which, if correctly addressed, may help in the maintenance of sound mental health among professionals.
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Needs of patients with opioid dependence: Are the perspectives of substance use disorder – Patients and their family caregivers similar? p. 125
Denny Mariam Oomen, Sandhya Gupta, Siddharth Sarkar, Y Surbala Devi
Context: There are more than ten thousand opioid-dependent patients visiting the study setting annually, depicting the serious public health issue associated with opioid use. The upheaval in all phases of life of a patient necessitates active involvement of both patient and caregiver. The importance of need assessment of patient by patients themselves and their caregivers need to be separately assessed to provide holistic care to patients. Aim: The aim of the study was to assess the needs of patients with opioid dependence syndrome as perceived by patients themselves and their family caregivers. Setting and Design: A comparative cross-sectional study conducted in a drug dependence treatment facility in India. Subjects and Methods: The needs of 105 opioid-dependent patients perceived by patients themselves and their family caregivers were assessed using Camberwell Assessment of Need Short Appraisal Schedule. Results: The most common unmet needs of patients as rated by patients themselves were physical health, money, and company. The most common unmet needs of patients rated by caregivers were money, looking after home and daytime activities. The agreement of needs of patient was poor in domains such as self-care (k = 0.17), looking after home (k = 0.16), company (k = 0.13), physical health (k = 0.10), money (k = 0.09), and psychological distress (k = 0.06). Conclusion: Addressing the needs of patients with opioid dependence might help in developing a more holistic management plan which will improve treatment outcomes. Nurses should be active part of communication system and fill the gap existing in the needs of patients.
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Lived experiences of the wives of alcohol use disorder partners: A phenomenology study p. 131
Naorem Bijyarani Devi, Mini George
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A comparative study to assess the resilience among patients with neurotic and stress-related disorders with normal counterpart in a selected hospital Tezpur, Assam p. 140
Deepa Das, Arunjyoti Baruah
Context: Health is a multidimensional concept, denoting not only an absence of disease and disability, but also feeling of happiness and welfare. Stress is among the important factors threatening mental health, and people are faced with numerous stressors in their everyday lives. Accumulation of daily stress would affect individuals' physical and mental health, and when it lasts for long term, it can lead to negative outcomes, including neurotic and stress-related disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, because the person who is resilient does not develop neurotic and stress-related disorders because this resilience shield people against the development of stress-related disorder. Aim: This study was conducted to find if there is a significant difference in the scores on measures of resilience between patients with neurotic and stress-related disorders with normal counterpart. Methods: The sample comprised 60 participants, 30 with neurotic and stress-related disorder, and 30 their normal counterpart. Participants were administered Connor–Davidson Resilience Scale (CD-RISC-25), General Health Questionnaire-12, and sociodemographic pro forma. Results: Significant differences were found in the resilience score of neurotic and stress-related disorders' patients with normal counterpart (t = 18.524, P = 0.000). Conclusion: CD RISC-25 showed the mean score of resilience among neurotic and stress-related disorders' patients were found to be 34.86 ± 9.35, and the counterpart scored the mean value of 85.66 ± 11.70 where the maximum possible score was 100. Resilience of counterpart was higher than neurotic and stress-related disorders' patients, (t = 18.524, P = < 0.000).
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A study to assess the prevalence of nomophobia among nursing students in Kollam p. 147
S Anand, KR Anoopa, Praveen George Joseph, Sajini Raju
Introduction: Nomophobia is an emerging human behavior stemming from widespread mobile phone use. Discovering the prevalence of nomophobia among nursing students is important as the use of smartphone in clinical practice may cause distraction affecting the quality of care and putting patients' safety at risk. Furthermore, it can lead to poorer academic performance. Materials and Methods: Quantitative approach with descriptive cross-sessional design was used in this study. The study was conducted in Bishop Benziger College of Nursing, Upasana College of Nursing, VNSS College of Nursing, and Holy Cross College of Nursing, Kollam, Kerala. The target populations were BSc nursing students. The purposive sampling technique was used to collect the data. Formal permission was taken by the institutional ethics committee and consent from the nursing students and data were collected through Google Forms. The tools used consisted of Demographics Pro forma and Standardized Nomophobia Questionnaire which is 7-point self-reporting questionnaire (not at all nomophobia, mild nomophobia, moderate nomophobia, and severe nomophobia). The collected data were analyzed using descriptive and inferential statistics. Results: The mean age of the participants was 21 years. More than 50% of nursing students use smartphone for about 5 h daily. Totally, 42% of nursing students having the habit of checking their smartphone <10 times/day. Nursing students affected by severe nomophobia were very minimal that were only 2%. (moderate 33%, mild 54%, and no nomophobia 11%). The prevalence rate of nomophobia among nursing students was 34.84. Significant association was found between nomophobia among nursing students and demographic variables such as level of study, smartphone use duration, frequency of checking phones, and frequency of checking phone episodes at 0.05 level. Conclusion: Smartphone addiction is a growing phenomenon in the current world. Online classes are influencing the duration of smartphone use. More than 50% of the private college nursing students are having mild nomophobia.
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Prevalence and pattern of learning disability in India: A systematic review and meta-analysis p. 152
Johny Kutty Joseph, Babitha K Devu
Introduction: Specific learning disorder (SLD) is a much common concept widely discussed nowadays. Specifically, it is a neurodevelopmental disorder found in children and adults. According to the Diagnostic and Statistical Manual of Mental Disorder (DSM)-V, SLD stands for a group of disorders that impedes the ability to learn or to use the requisite academic skills. It comprises impairment in reading, writing, and mathematical ability. Aim of the Review: This systematic review aimed to identify the prevalence and pattern of learning disability among children of India. Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is also registered under PROSPERO vide CRD Number: CRD42021286224. The literature search was done using Boolean operators in databases such as PubMed, ProQuest, Cochrane, ScienceDirect, Google Scholar, and websites such as ResearchGate, Academia, and so on. The literature search was focused on Indian studies conducted between 2000 and 2020 (20 years). The initial search identified 122 articles across the databases. Following the screening process and removing the duplicate files, 20 articles were included in the review. According to the predetermined protocol, the researcher independently searched, reviewed, collected, extracted, and evaluated the requisite data and relevant information from each research article. Each individual research article was assessed for its quality using the “critical appraisal tool for use in systematic reviews addressing questions of prevalence.” In the current review, considering the heterogeneity between the studies with regard to sample selection, geographical location, and instrument used for data collection, a random-effect model was adopted. The statistical evaluations were done through OpenMeta (Analyst). Results and Discussion: The prevalence of learning disability among Indian children ranges from 2.16% to 30.77% across the studies. The pooled prevalence of LD among children and adolescents is estimated to be 10.70% (95% confidence interval [CI]: 7.10% to 14.3%), and the median age was 6–12 years. The prevalence of dyslexia among children and adolescents is estimated to be 6.20% (95% CI: 4.40% to 7.90%; I2 = 97.01% P < 0.001), while the prevalence of dysgraphia is estimated to be 6.30% (95% CI: 3.60% to 9%; I2 = 97.83% P < 0.001). Moreover, the prevalence of dyscalculia is much lower and it is estimated to be 4.90% (95% CI: 2.60% to 7.20%; I2 = 97.59% P < 0.001). The finding of this review is consistent with another review by the National Survey of Children's Health, USA, which estimated the lifelong prevalence of learning disability to be 9.7% in children (USA) from 3 to 17 years of age. Conclusion: The finding of the review explains that learning disability affects quite a large number of Indian Children. The information from the current review may set a benchmark to assess the disease burden of the country and it will be a reference for resource planning and health-care policymaking.
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Effect of anti-tobacco health messages post-implemetation of COTPA 2003 in India p. 163
Laxmi Kumari, Meenakshi Sood, Sandhya Gupta
Tobacco-related deaths are rising, although it is a preventable man-made epidemic. Globally, tobacco accounts for the death of 6 million people each year. The tobacco industry very intelligently uses the mass media platform for pro-tobacco propaganda messages. India made a significant attempt to fight tobacco by endorsing the WHO Framework Convention on Tobacco Control in February 2004. The WHO has introduced the MPOWER package of six proven policies to reverse the tobacco epidemic and prevent millions of tobacco-related deaths. Surprisingly, with all the awareness about these harms related to tobacco consumption and anti-tobacco campaigns at national and international levels, tobacco users do not feel motivated to quit. Anti-tobacco health messages (ATHMs) are crucial in affecting tobacco-related health behavior. This review summarizes the effect of ATHMs on the Indian population and the influences of different types of ATHMs on motivation to quit tobacco and tobacco cessation as a whole. Depending on the group investigated, ATHM effects on smoking behavior vary. ATHMs can influence people's attitudes and beliefs, improve intentions to stop and quit attempts, and decrease tobacco use dominance. They can also play a crucial role in educating the public about the dangers of tobacco use. The government must concentrate on rational ATHMs with broad appeal, ongoing exposure, and a preference for negative health effects with visual and live testimonial ads.
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Medication adherence and role of psychiatric nurse p. 171
Kankana Chakraborty, Sandeep Kollipara
Pharmacotherapy is the most common strategy used for restoring health. Taking treatment has a positive outcome on the illness but in between treatment and outcome, an important role is played by adherence. A systematic review and meta-analysis found the prevalence of nonadherence ranges from 7% to 83%. Nonadherence can be of different types such as primary nonadherence where medication was prescribed but never initiated by the patient; secondary nonadherence where the medication is not taken as prescribed and nonpersistent; and nonadherence where the medication is stopped without the physician's order after starting. Poor socioeconomic status, low level of education, long distance, cost of medication, cultural belief, poor patient–provider relationship, overburden of health-care provider, chronic disease condition, asymptomatic condition, complex medical regimen, long duration treatment, misunderstanding of treatment instruction, medication side effect, and forgetfulness are the most common factors affecting adherence. Although there are no gold standards for assessing adherence, some subjective methods, for example, patient-kept diaries, interviews, and objective methods such as determining the presence of drugs in a patient's body fluid and the use of electronic monitoring can be taken into consideration. Nurses are playing an important role in guiding the patient and their family members regarding different ways to be adherent to medication by providing psychoeducation, motivational interview, different behavioral therapies, compliance therapy, and cognitive behavioral therapies. They should be nonjudgmental and address specific issues during discharge counseling of patients and families for better adherence.
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Perceptual ineptness in relation to drug addiction p. 176
Nuzhat Firdous
Addiction of any kind is indeed detrimental, leading to psychological, financial, and social disorders. However, drug addiction is seen as one of the major concerns worldwide, having the most distressing consequences. This may be attributed to a number of psychosocial factors which put a person at a greater risk to develop such behavior. For some, drugs provide a kind of relief in times of distress, and for others, it increases the confidence level and improves the performance on a given task. Several studies have been carried out so far highlighting various precipitating/perpetuating factors (parental neglect, discord, peer pressure, lack of coping and resilience, and social incompetence) in maintaining such behaviors, as well as the preventive ones (authoritative parenting, extended family system, and enhanced psychological capital) to overcome this menace. What makes it more challenging is holding a fallacious belief of baking (roasting) the weed (Charas) as a skill and smoking as a means of lifting one's morale and a matter of prestige. This may be attributed to the germination of a thought of exhibiting the power of masculinity before the same or the opposite sex and thus eventually sidelines the efforts made by the stakeholders to restrict the ill effects of drug addiction on youth and on society as a whole. There is thus a pressing need to educate young minds and restructure their belief system at a very early stage of development. In that direction, all the institutions (family, school, and place of worship) must go hand in hand to ensure that youth is aware about the ill effects of such illicit behaviors, well in advance.
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Research on panic buying behavior: What are the challenges faced by researchers? p. 179
Babli Kumari, Nitika Singh, Sujita Kumar Kar
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Mental health nurses: Untapped potentials during COVID-19 for mental health services p. 181
M Vijayarani, G Balamurugan
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