Caregivers of stroke survivors: new role and new responsibility

A stroke is a massive blow not only to the patient, but also to his/her relatives and friends. II may produce a dramatic change in life style and in the patient's role within the family. The care at home for the stroke survivors is often transferred to a family member with no previous experience in caring for someone who suffered from stroke. However, since stroke survivors often are left with long-term disabilities, families are usually the informal health system, which the patient is likely to depend on for sometime. So it was important to assess knowledge and practice of family care-givers of stroke survivors. It was also important to assess the psychological effect of having to care for a stroke patient at home for a long time. Fifty caregivers of stroke survivors were included in the study. They were chosen from El-Manial University Hospital. Tools for data collection included: [A] Data about stroke survivors; [1] demographic data sheet, which included data regarding age, sex, weight and height, and [2] index of Activities of Daily Living [ADL]. [B] Data about caregivers; [1] demographic data sheet which included data such as age, sex, marital status, education, occupation and relationship to patient, [2] a structured questionnaire to assess the care-givers' knowledge regarding risk factors and warning signs of stroke, also knowledge regarding medication management and side effects., diet and exercise, and [3] Hamilton Depression Rating Scale [HDRS], Data were collected through an initial visit in the hospital and two follow-up home visits which were one month apart. Scores of the ADL in the initial visit were used to divide stroke survivors into tow groups: group [1] patients with very severe disability, and group [2] patients with moderate disability. Results revealed that more than three quarters of caregivers were females. A little over half of the care-givers in the sample were single which may explain their readiness to perform the caregiver's role. The study results revealed lack of knowledge of most care-givers regarding balanced diet and side effects of prescribed medications. This result may reflect unsatisfactory discharge planning. In relation to Hamilton Depression Scale, results indicated that' while only group one caregivers developed depression starting from the first visit, both groups developed depression by the third visit. Generally, more attention should be given to preparing caregivers for their new role. Also, adequate information and training need to be made available to caregivers. This will positively be reflected on the quality of life of both stroke patients and their caregivers

Nutritional status and pressure ulcer development in elderly: implications for nursing practice

As life expectancy increases so do the problems of the elderly population One major problem is that of protein-calorie malnutrition' another is the susceptibility of this population to pressure ulcers. The effect of undernutrition on increasing morbidity and mortality is well documented. Residents of acute and long-term care settings who are undernourished are more susceptible to pressure ulcers [1]. Determining whether an elderly patient is malnourished can be surprisingly difficult. However, perhaps the most useful indicators of malnutrition in elderly patients are loss of body weight from baseline, decreased dietary intake, and low serum albumin [11]. Therefore the purpose of this research was to identify elderly adults at risk of developing pressure ulcers, and to examine the relationship between nutritional status and pressure ulcers development among elderly in selected acute care and nursing home settings. One hundred twenty six elderly persons from two orthopedic sections in a university hospital and a nursing home in Cairo aging 65 years and older with no pressure ulcers were approached. Their nutritional status was assessed using anthropometric measures and laboratory tests. Results of the study indicated significant inverse relationship between serum albumin and development of pressure ulcers among elderly. Weight indices were also significantly correlated with pressure ulcer development. When comparing subjects in the orthopedic sections with those in the nursing home it was clear that nursing home residents were apt to show more weight loss, more inadequate nutritional intake and lower serum albumin level, i.e. malnutrition than those in the orthopedic sections. Hence, they were more at risk for developing pressure ulcers. Generally, monitoring for nutritional deficiencies helps to identify high-risk persons and allows caregivers time to institute preventive measures before a deficiency becomes clinically apparent. Risk assessment for malnutrition and/or pressure ulcers is recommended upon admission to geriatric homes and acute care settings and periodically afterwards Further investigation of the relationship between nutritional support regimens and the incidence of pressure ulcers are recommended

Osteopososis and determinants of fractures among menopausal women

A total of 304 women was selected for this study. The results indicated that increasing age, caffeine intake, family history of a lack of exercise, low body weight, number of pregnancies and long-term use of certain medications had a deleterious effect on the bone density. The risk prediction of osteoporotic fractures that incorporated clinical risk determinants along with BMD measurements was an important endeavor in identifying persons at risk for fractures and for whom intervention measures should be directed

Nursing manpower in primary health care units in three governorates in Upper Egypt: situation analysis

A survey study was conducted using a sample of 1587 nurses utilizing four semi-structured questionnaires. The results indicated that in Assuit 34.8% of nurses are working in primary care facilities, in Sohag 48.3% and in Menia 33.5%. The majority of these nurses are young diploma graduates. The vast majority of these nurses did not receive pre- employment training and most of them did not receive in- service training. More than 90% of nurses in the three governorates indicated that they were being evaluated periodically by their superiors, and that the evaluation was mostly written and they get a chance to see it. Nursing school officials indicated that discrepancy between planned versus actual clinical training activities reflects negatively on graduates' performance upon employment

AIDS, knowledge, attitudes, and beliefs among nurseeducators

The purpose of this study was to assess the knowledge, attitudes and beliefs of nurse-educators about AIDS. A convenient sample of 50 staff members in the High Institute of Nursing, Cairo and Ain-Shams Universities was included. Sample subjects were asked to fill out a 25-item self-report questionnaire. 82% of the subjects indicated that AIDS is caused by a virus. 70% believed that AIDS can be cured if treated early. Ironically, the same percentage [70%] believed that there is no cure for AIDS. All subjects indicated that AIDS is a life-threatening disease