Kim Lam Soh

Perception of Intensive Care Unit stressors by patients in Malaysian Federal Territory hospitals

The Intensive Care Unit (ICU) is a therapeutic place for monitoring critically ill patients. However, it is a stressful area for the patients and it is causing them great anxiety. Previous studies have identified three groups of stressors in ICU namely; physical, psychological and environmental. The aims of this study were to determine the ICU stressors as experienced by patients and to determine the level of stressors felt by patients in ICU. A cross sectional study was done on 70 patients from two tertiary hospitals in Malaysia. A face-to-face interview with structured questionnaire was used for patients. Data collection occurred from 15 December 2006 to 31 January 2007. The five major ICU stressors perceived by patients were pain, being stuck with needles, boredom, missing their spouses and being too hot/cold. The ICU physical stressors were the major items ranked by post ICU patients. The findings from this study provided a set of baseline information to the health care providers, particularly ICU nurses in Malaysia, with which to provide better care for the patients in ICU.

Blood Profiles among Female Undergraduate in Iraq After a 12-Weeks Home-based Intervention Program

The aim of this study is to investigate whether a 12-weeks home-based intervention program could improve blood profiles among female students in Iraq. A 12-week home-based intervention which consisted of physical activity and dietary awareness program was carried out at home. The subjects were 44 sedentary undergraduate female students from Soran University, Iraqi. Both experimental and control groups (n=22 in each group) completed practical tests at baseline pre-test, post-test1, and post-test2, but only the experimental group participants received the 12-weeks intervention program. The blood profiles measured were blood pressure, blood cholesterol, and blood glucose. Results showed that the experimental group demonstrated improvement in diastolic systolic blood pressure after undergone 6 weeks post-test intervention program. The reported f value was (F(2, 84)=-6.636, p=.047, η2=0.091). Significant blood profiles results were reported for diastolic blood pressure and blood glucose. However, the significant results were only reported after the subjects had undergone the 12-weeks intervention program. The reported f values were (F(2, 84)=-7.000, p=.007, ?2=0.163) and (F(2, 84)=-16.182, p=.003, η2=0.188), respectively. As the conclusion, a home-based physical activity and dietary intervention program can positively influence sedentary undergraduate female students’ blood profiles and the benefits can be achieved as early as after 6-weeks.

Effect of a Nurse-Led Diabetes Self-Management Education Program on Glycosylated Hemoglobin among Adults with Type 2 Diabetes

In recent years, great emphasis has been placed on the role of nonpharmacological self-management in the care of patients with diabetes. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors was designed. One hundred forty-two adults with type 2 diabetes were randomized to receive either usual diabetes care (control group) or usual care plus a nurse-led diabetes self-management education (intervention group). Duration of the intervention was 12 weeks. The primary outcome was glycosylated hemoglobin (HbA1c values). Secondary outcomes were changes in blood pressure, body weight, lipid profiles, self-efficacy (efficacy expectation and outcome expectation), self-management behaviors, quality of life, social support, and depression. Outcome measures were assessed at baseline and at 12-week and 24-week postrandomizations. Patients in the intervention group showed significant improvement in HbA1c, blood pressure, body weight, efficacy expectation, outcome expectation, and diabetes self-management behaviors. The beneficial effect of a nurse-led intervention continued to accrue beyond the end of the trial resulting in sustained improvements in clinical, lifestyle, and psychosocial outcomes. This trial is registered with IRCT2016062528627N1.

THE TREND OF ENTERAL FEEDING AMONG CRITICALLY- ILL PATIENTS IN ADULT ICUs IN MALAYSIA

The adequacy of caloric intake is crucial for all critically-ill patients in Intensive Care Units because energy expenditure is higher in these patients compared to normal patients in general wards. Adequate calorie intake will promote positive outcome to the patients while inadequate calorie will lead to malnutrition which will increase the length of stay. The objective of this study was to determine the adequacy of caloric intake received by critically-ill patients in the general ICU in Malaysia. This was a cross sectional study which used a proforma adapted from ICU protocol. There were 132 participants involved in this study. The descriptive statistic and independent t-test were used for the statistical analysis. The results showed that 75.8% (n=100) received adequate or more than calorie prescribed while 24.2% (n=32) received calorie less than the given prescription. Patients that received early feeding were 72% (n=95) and late feeding were 28% (n=37). The continuous feeding method was most commonly used in early feeding patients from Day 1 to Day 3. There was an association between the adequacy of calorie intake and the length of stay (p<0.05). Findings obtained from this study will provide information for the nurses and other health care providers to improve the management of patients so that all patients will receive adequate caloric intake during their stay in ICUs.

PAIN MANAGEMENT KNOWLEDGE AMONG MEDICAL WARD NURSES IN MALAYSIA

Pain, a common symptom for patients in medical wards, can be relieved by effective pain management, with nurses playing a vital role in this regard. A study was undertaken to determine the knowledge of nurses on pain management and to examine the factors that influence their acquisition of such knowledge. A total of 143 medical ward nurses (representing 60% response) in a government referral hospital in Malaysia participated in the study. Data from this study derived from a set of questionnaires were analysed using 2 x 2 contingency tables and the chi squared test with Yate’s correction. Approximately two thirds of the nurses were deficit in knowledge regarding pain management, registering a mean knowledge score of 40.5 out of a possible 100 points. There was no significant association between the level of knowledge on pain management and demographic characteristics such as age and work experience. There was also no significant relationship between the level of knowledge on pain management and the pain courses attended. A better understanding of the factors that affect the acquisition of such knowledge could provide useful information that can be incorporated in an improved educational program on pain management for nurses.