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   Table of Contents - Current issue
Coverpage
January-June 2022
Volume 19 | Issue 1
Page Nos. 1-96

Online since Tuesday, July 5, 2022

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EDITORIAL  

Editorial p. 1
Sandhya Gupta
DOI:10.4103/iopn.iopn_44_22  
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ORIGINAL ARTICLES Top

Index of online teaching stress and quality of life among nurse educators during COVID-19 Highly accessed article p. 2
Shiv Kumar Mudgal, Kavita Verma, Suchpreet Kaur Gill, Rakhi Gaur, Digpal Singh Chundawat, Ravikant Sharma
DOI:10.4103/iopn.iopn_48_21  
Background: With sudden changes in the worldwide education system due to COVID-19 impact and limited available resources, nurse educators have been suffering from online teaching stress in this year, which is thought to affect their quality of life (QOL). The aim of this study was to ascertain the index of online teaching stress and QOL among nurse educators during COVID-19. Subjects and Methods: In this cross-sectional study 162 nurse educators were recruited through a convenient sampling technique. Online survey was employed using socio-demographic questionnaire, online teaching stress scale, and World Health Organization QOL BRIF-26 to collect data. IBM Statistical Package for the Social Sciences (SPSS) Version 23 was used for statistical analysis. Results: Among all participants, 22% and 51% of participants reported severe and moderate level of online teaching stress respectively. The highest and lowest overall QOL was reported in the social relationship (70.29 ± 20.5) and physical health (54.54 ± 13.73) domain. Online teaching stress scores were significantly associated with gender (P = 0.012), teaching experience (P < 0.001), salary (P < 0.001), job satisfaction (P < 0.001), satisfaction with organization (P < 0.001). Online teaching stress scores were significantly negative correlated with all four domains of QOL. Marital status and monthly salary were the indicators of online teaching stress. Teaching experience, salary, and job satisfaction appeared to be robust predictors for domains of QOL (P < 0.05). Conclusion: The findings suggest that effective interventions primarily focusing on improving the availability of resources, training, and empowerment activities are necessary to decrease the negative effect of stress on QOL.
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Exam Anxiety and Factors Influencing Exam Preparation: A Mixed Method Study Highly accessed article p. 9
L Manoj Kumar
DOI:10.4103/iopn.iopn_69_21  
Background: The time of examination is a stressful period for students. However, an optimum level of stress can help in motivating the students, this stress can be from test anxiety which arises from stimuli of being tested or judged academically. Nursing students experience a higher level of exam anxiety comparing to students from other disciplines. Aims and objectives: This study aimed to assess the level of exam anxiety perceived by nursing students in selected setting. Along with exam anxiety; this research explored factors influencing exam preparation among nursing students. Material and methods: A mixed-method research study was conducted to assess test anxiety and to explore factors influencing their exam preparations. Total enumeration sampling technique was used to recruit 272 BSc nursing students from a nursing college attached to a tertiary care hospital in South India. Data were collected using a sociodemographic pro forma, a test anxiety scale to assess test anxiety, and a focus group discussion (FGD) was conducted using an FGD guide to explore factors influencing exam preparations of nursing students. Demographic data and test anxiety scores were analyzed using frequency and percentage. Qualitative data recorded were transcribed and identified repeated concepts, then coding was done to develop themes. Results: The study revealed that more than half of subjects 53.3% (145) having high exam anxiety, followed by 39.7% (108) subjects who had medium exam anxiety and 7.0% (19) had low exam anxiety. On comparison of mean test anxiety scores, the mean test anxiety score of first-year BSc nursing students (21.88 ± 5.384) remained higher than the second year (20.06 ± 4.403), third-year (19.17 ± 4.529), and fourth-year (20.84 ± 4.857) nursing. From FGD, three themes emerged as nursing students described their experiences and feelings toward factors influencing exam preparation. (1) Materialistic and environmental factors for exam preparation. (2) Motivational determinants that promote exam preparation. (3) Perceived barriers or distractions in preparing for an exam. Conclusion: This study concludes that faculty who are in close association with students can improve student outcomes by early identification of test anxiety, intervening if necessary, and sometimes by referring to a psychiatrist for ruling out further mental health issues that may arise from exam anxiety.
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Lived experiences and ensuing notion of staff nurses as COVID-19 survivors in India: A phenomenological approach p. 16
Pushpa Oraon, Rajni Thapa, Johny Kutty Joseph, Rupali
DOI:10.4103/iopn.iopn_61_21  
Background: Nurses are central to the entire spectrum of responses to the novel coronavirus (COVID-19) pandemic including the mental health effects of the outbreak. Methods: This study investigated a significant number of Physiological and Psychological Experiences and Ensuing the notion of staff nurses as COVID-19 Survivors using Phenomenological Approach. A total of 12 interviews were conducted with 12 participants. Results: The study result was described into five main thematic categories which included Preparedness for COVID-19, Physiological Experiences, Practices Social Distancing, Psychological Experiences, and Ensuing notion toward pandemic. We found that nurses were presented with mild-to-moderate physiological symptoms of COVID-19 illness. As well as, negative psychological experiences existed in the early stage of recovery among nurses; later they themselves developed optimistic and adjustment approaches to cope up with the situation to stay mentally healthy. Conclusion: In the ensuing notion Nurses' suggested to follow the Universal Precautions, Self coping style and more emphasizes to add herbal and ayurvedic remedies in their balanced diet.
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SocioDemographic variables and social connectedness as predictors of coping mechanisms in college students during COVID-19 pandemic p. 28
Samina Bano, Tanushree Deka
DOI:10.4103/iopn.iopn_79_21  
Purpose: The outbreak of the COVID-19 pandemic has left the student community in distress. They have had to vacate their hostels and go home, which has restyled their enjoyable campus life into virtual online classes. The technical glitches and uncertainty of the future kept them in the doldrum. Our study explored the subgroups of socio-demographic variables (gender, educational qualifications, history of mental health condition, current experience of mental health condition, and current accommodation) and Social Connectedness as predictors of coping strategies during the pandemic in university students of Delhi-NCR. Method and Materials: A cross-sectional research design was implemented. Through purposive sampling, 248 students were recruited. The sample consisted of males and females aged 18-34 years (Mean=21, SD=2.86). Data was collected using Google forms consisting of the Sociodemographic Form, The Brief Cope and Social Connectedness Scale. Online informed consent was taken from the participants. Results: Regression results suggested that the current experience of mental health conditions predicted active emotional and avoidant emotional coping strategies. Social Connectedness positively predicted avoidant emotional coping strategy and negatively predicting problem focus strategies in the COVID-19 pandemic. Significant differences were found in active emotional and avoidant emotional coping strategies between students having a past and current history of mental health conditions (anxiety/depression) vs. those who were in sound mental health. Students with past experience of mental health issue were reported to be significantly more socially connected than who did not have any mental health issue. Conclusions: The potential effects of Social Connectedness, a history of the mental health condition on coping strategies during COVID-19, were found to be necessary.
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Optimism, Quality of Life, and Psychological Distress in Patients with Type 2 Diabetes Mellitus: A Case–Control Study p. 35
Ottilingam Somasundaram Ravindran, Natarajan Shanmugasundaram, Saidivya Madhusudhan
DOI:10.4103/iopn.iopn_50_21  
Background: Type 2 diabetes mellitus (T2DM) is a serious chronic illness which has a major impact on the psychological well-being of the individuals. Aim: This case–control study compared the optimism, quality of life (QOL), and psychological distress between T2DM persons and healthy controls and examined the relationship of optimism with QOL and psychological distress among T2DM persons. Materials and Methods: Using a purposive sampling technique, this study was conducted in the General Medicine Outpatient department of a tertiary care hospital between January and March 2020. Fifty participants (25 cases and 25 healthy controls) in the age range of 30–60 years took part in the study. Both groups were assessed by the following instruments: Life Orientation Test-Revised, WHOQOL-BREF, and Depression Anxiety and Stress Scale. Results: T2DM persons are experiencing significant psychological distress with a pessimistic disposition and reduced QOL. Furthermore, optimism was positively correlated with psychological health among T2DM persons. Conclusions: T2DM persons are found to be pessimistic and distressed with significant reductions in their QOL.
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Role of media on perceived vulnerability of the public at early stage of COVID-19 pandemic p. 43
Deldar Morad Abdulah, Rasoul Sabri Piro
DOI:10.4103/iopn.iopn_73_21  
Introduction: The outbreak of the novel coronavirus has spread across the world. The COVID-19 pandemic could have a considerable psychological effect. We aimed to explore the role of media on the level of perceived infectability and germ aversion toward coronavirus infection of the public at early stage of the pandemic. Methods: In this study, 708 individuals who live in different geographical locations of the Duhok Governorate in Iraqi Kurdistan were included between March 16 and 25, 2020. Results: The mean age of the participants was 27.40 (18–74 years). The participants reported that traditional news services have a relaxing role regarding the coronavirus pandemic (58.3%) in contrast to a stressing role of social media (64.7%). The mean values of vulnerability, perceived infectability, and germ aversions to COVID-19 infection were 4.74, 3.99, and 5.49 of 7.0, respectively. Participants who considered social media to have a stressing role were more likely to be bothered when someone sneezes without covering their mouths (4.45 vs. 4.04; P = 0.044). In addition, they were more likely to think that they catch an infectious disease (3.89 vs. 3.51; P = 0.016), and have a less strong immune system to protect them from most illnesses (2.85 vs. 2.40; P < 0.001), respectively. Conclusions: This study showed that social media has a stressing role to the public regarding COVID-19 infection.
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Family attitude toward the persons with negative symptoms of schizophrenia p. 47
Chanamthabam Padmini Roy, Arunjyoti Baruah
DOI:10.4103/iopn.iopn_44_21  
Background: Negative symptoms of schizophrenia not only lead to poor interpersonal relationship, impaired social and work functioning of the clients but it also affects family members in various aspects. The present study aimed to assess the attitudes of the primary caregivers toward the clients with negative symptoms of schizophrenia. Materials and Methods: A cross-sectional study was conducted at tertiary care hospital of Assam. Through purposive sampling technique, 40 primary caregivers of clients with negative symptoms of schizophrenia were selected from the indoor setting of a tertiary mental care institute. Self-structured sociodemographic and clinical Proforma, Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), and Family Attitude Scale (FAS) were used to collect the data. Data were analyzed using the descriptive and inferential statistics. Results: Majority of the participants (87.5%) score <60 in the FAS which showed low expressed emotion toward the clients with negative symptoms of schizophrenia. A significant negative correlation was found between the SANS score and monthly income of the clients (r = -'0.446, P = 0.004). Conclusion: Attitude of the primary caregivers toward the patient may vary based on the symptoms of schizophrenia. Assessing their attitude in the form of expressed emotion may help to understand their perception during the care of patients with negative symptoms of schizophrenia. This may help to plan suitable psychosocial nursing care for the primary caregivers.
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A study to assess the efficacy of audio-visual psychoeducation on level of knowledge and attitude regarding harmful effects of alcohol among alcohol use disorder patients admitted to mental health units of selected hospitals of Western Maharashtra p. 54
Seema Madhavan Nair, Punita A Sharma, Radhika Das
DOI:10.4103/iopn.iopn_22_21  
Introduction: Alcohol use disorder (AUD) has emerged as a global concern in the world, due to its harmful impact on health, social, economic, and legal aspects. Several established treatment approaches, both pharmacological and nonpharmacological are available but have only modest success. Relapse in alcohol use is noted to be common following treatment, hence efficacy of newer modalities of treatment or therapies is needed. Aim: This study aims to assess the efficacy of audiovisual psychoeducation on the level of knowledge and attitude of harmful effects of alcohol among AUD patients admitted to mental health units of selected hospitals of Western Maharashtra. Materials and Methodology: A quantitative research approach with pretest-posttest control design was adopted in the study. The sample size was estimated to be 70 based on the pilot study and settings were mental health units of selected hospitals in Western Maharashtra. A simple random sampling technique was used with random allocation of subjects into experimental group and control group by lottery method. A structured tool to assess knowledge was developed, validated by experts and reliability was tested. Alcohol Decisional Balance Scale, which is a standardized tool was used for assessing the attitude. Pretest knowledge assessment was done for control and experimental groups. Audiovisual psychoeducation was given to the experimental group. Both the groups were receiving routine care. A posttest assessment was done after 7 days of intervention. Results: Findings revealed that there is statistically significant increase in the level of knowledge from pretest mean score of 9.37 + 3.191–14.06 + 4.179 in posttest of the experimental group by Wilcoxon Z value test at the level of significance P < 0.0001 showing the efficacy of audio-visual psychoeducation in changing the level of knowledge. Similarly, postintervention attitude distribution assessment in the experimental group revealed a statistically significant difference in positive attitude from 6 (17%) in pretest to 12 (34%) in posttest with the McNemar's test at level of significance of P < 0.031. Correlation in level of knowledge with attitude revealed a weak positive correlation with r = 0.17. There was no significant association of pretest knowledge with selected socio-demographic data. Conclusion: Audiovisual psychoeducation is efficient in increasing the level of knowledge and change in attitude toward harmful effects of alcohol.
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Effectiveness of structured teaching program on nurses' knowledge on safe handling of psychotropic drugs p. 61
SV Harsharaja, Radhakrishnan Govindan, Rajalakshmi Ramu, Dinakaran Damodharan, Arun Kandasamy
DOI:10.4103/iopn.iopn_9_22  
Background: Nurses play a major role in the management of psychiatric patients including the administration and handling of psychotropic drugs. They are in a pivotal position to educate the patient and family members about the medication and they should possess knowledge and competencies of psychotropic drugs to ensure safety. Materials and Methods: The authors have applied quantitative approach, preexperimental design, one group pre-test and post-test design for this study. Fifty-two newly recruited nursing officers were participated in this study. The authors have assessed the nurses' baseline knowledge on psychotropic drugs and the safe handling of such drugs. Followed by that, structured Teaching Program (STP) was designed, developed, and imparted to improve the nurses' knowledge and skills on psychotropic drugs by the authors. A post-STP assessment was conducted to identify the change in nurses' knowledge. Results: Baseline assessment revealed that the nurses were obtained poor scores in knowledge on psychotropics scale and safe handling of psychotropics scale. The median pretest score was seven on knowledge of psychotropics scale and four on the safe handling of the psychotropics scale. Two weeks' posttest scores were 15 and 11, respectively. The results showed significant difference between pre-test and posttest median scores and Wilcoxon signed-rank test (P < 0.001). Sociodemographic variable such as the age of the participants was correlated positively with baseline scores of safe handlings of psychotropic drugs and their post-graduate training in psychiatric nursing was associated with knowledge score. Conclusion: The results of the study revealed that the STP me about knowledge on psychotropic drugs and safe handling of psychotropic drugs was effective in improving the knowledge of newly recruited staff nurses. Continuing nursing education on psychotropic drugs and its safe handling skill among nurses may result in better psychiatric nursing care outcomes.
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REVIEW ARTICLES Top

The efficacy of educational intervention in enhancing person's ability to manage their epilepsy well: A systematic literature review p. 66
Rinki Ghosh, Arunjyoti Baruah
DOI:10.4103/iopn.iopn_81_21  
Epilepsy is one of the most common chronic neurological conditions, with the potential to generate significant morbidity, impaired quality of life, socioeconomic decline, and high health care costs. Self-management is essential for patients who live with a chronic disease. In addition to standard therapeutic options, patients are also urged to engage in epilepsy self-management which is best achieved by delivering educational intervention to enhance their self-management skills. A good self-management enhances self-efficacy and improves overall quality of life. The purpose of the current review was to identify the evidence on the efficacy of educational intervention in enhancing person's ability to manage their epilepsy to improve their quality of life. Various online databases were searched to obtain the literature using appropriate search terms/keywords. Only Randomized controlled studies were included in the review because of their high evidence level and to avoid subject to bias. Databases searched were ScienceDirect, Wiley online library, and Google Scholar. A total of 41 articles with full texts were reviewed, out of which 7 articles met the criteria. The methodological quality of the studies was assessed by using the Jadad scoring system. The outcome measurement of self-management, self-efficacy, drug adherence, quality of life was observed among patients with epilepsy (PWE) and found effective after delivering educational intervention. In the entire studies, the control group received routine care. This systematic review of randomized controlled trial studies emphasized the positive impact of educational interventions for patients diagnosed with epilepsy concerning various outcome measures. Hence, It was concluded that the planned educational intervention empower PWE to engage in good self-management practices and it enhances their self-efficacy, quality of life by improving their sleep quality, decreasing stress, concern, and fears related to epilepsy.
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Update on critical issues and current challenges with “newer psychoactive substances: An narrative review” p. 75
Raka Jain, Kamini Verma
DOI:10.4103/iopn.iopn_41_22  
In recent years, new psychoactive substances (NPS) (”legal highs” or “designer drugs”) are increasing worldwide. An increase in NPS is a cause for concern for drug-regulatory authorities and health-care professionals as it poses a threat to public health. Because of their novelty, these drugs go undetected by traditional detection methods, hampering adverse reaction assessment, and increasing challenges for laboratories and the regulatory system. This review aims to provide an update on the current state of NPS at the global level. The article addresses important issues and challenges in the clinical and forensic toxicology laboratories, which deals with testing for substances of abuse, the unclear legal status of NPS, and the limited knowledge of the public about their side effect. These issues and challenges would be important for health-care professionals, toxicologists, law enforcement authorities, and policymakers to take into account an effective response to control the use of NPS.
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CONCEPT PAPER Top

Well-being and pregnancy p. 83
Pallavi Talukdar, Arunjyoti Baruah
DOI:10.4103/iopn.iopn_72_21  
Well-being is a complex construct on the optimal functioning in one's life. Well-being is basically having two perspectives: hedonic approach (i.e., pain avoidance and pleasure attainment) and eudaimonic approach (i.e., living up to one's fullest potential). Over the years, researchers have explored various stages of one's life based on these approaches. Pregnancy is an important milestone of women's life. Pregnancy is a period of hope and growth. This concept paper has been drafted with the aim of having an understanding regarding well-being and its short-term as well as long-term impact on pregnant women and their unborn children. The objectives of the study were to get an overview on well-being and to understand its effect on pregnant women as well as their fetuses. The electronic literature search engines used were Google Scholar and PubMed for selecting papers related to the theme well-being and pregnancy. Again, these selected articles were further screened for more relevant literature. For the present paper, a total of 35 articles were reviewed which were published online. Assessment of well-being during pregnancy helps in the assurance of better future for both the mother and the child. In this paper, the researcher has looked into a comprehensive view of well-being, and this has an influence on the pregnant women. This understanding will help in the promotion of well-being and maternal health, which in turn will have a positive effect on the baby.
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CASE REPORT Top

Mealtime behavior in autism spectrum disorder: A case report p. 89
Tarubhi Agarwal, Neelima Asthana
DOI:10.4103/iopn.iopn_68_21  
Autism spectrum disorder is a neurodevelopmental disorder characterized by impaired social and communication skills and repetitive and restricted behaviors or interests. No exact cause has been determined that may be responsible for its occurrence. However, genetic and environmental factors could be responsible for this disorder. Autism spectrum disorder is one area where little research has been done regarding mealtime behavior and increasing prevalence of this disorder indicated a dire need to study this area. The study aimed to observe the mealtime behavior of 15-year-old adolescent boy during his mealtime and understanding the factors that might be responsible for the idiosyncratic mealtime behavior. Nonparticipatory observation method was used for about 1 month, and data were collected till the point of saturation, where the data collection process no longer offered any new or relevant data. Speech impairment, restricted interest, vestibular difficulties, interference, sensory issues, lack of social interest, and self-absorbed behavior were some of the factors that might be responsible for his idiosyncratic behavior during mealtimes. The study recommended that nutrition-based intervention programs must be initiated by the professionals as early as possible to minimize the effect of such factors during mealtime of people with autism spectrum disorder.
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LETTERS TO EDITOR Top

Psychosocial interventions for expressed emotion in bipolar affective disorder: A key to care p. 92
Kannappa V Shetty, Pavitra Arunachaleeshvaram, Vijaya Raghavan
DOI:10.4103/iopn.iopn_65_21  
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Role of information and communication technology in preventing the suicide p. 94
Kapote Shweta, Srikanth Pallerla
DOI:10.4103/iopn.iopn_17_22  
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FACT SHEET Top

Indian Society of Psychiatric Nurses (ISPN India) and Indian Nursing Counselling (INC) Counselling service for the Nurses in COVID-19 battle p. 96
G Balamurugan, G Radhakrishnan, M Vijayarani
DOI:10.4103/2231-1505.350857  
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