ABSTRACT
@#Introduction: The study’s objective was to validate a Malay language translated questionnaire on end-of-life care to be used among nurses practicing in critical care areas. Methods: The English language questionnaire underwent forward and backward translations by four experts. The translated Malay language questionnaire was pilot tested on 30 subjects and revised accordingly. The validation of the revised questionnaire was carried out on 250 nurses. The reliability of the translated questionnaire was checked. Cronbach alpha value of at least 0.70 suggests adequate internal consistency. The validity of the questionnaire was explored using Confirmatory Factor Analysis (CFA) and model fit tests were run to achieve fit test specific cut off values. The CFAs were run repeatedly with iterative item reductions until acceptable goodness of fit for the model was achieved. Results: All domains of the translated questionnaire showed reasonable to excellent reliability (Cronbach Alpha 0.687 to 0.922). Multiple CFAs were run and 13 out of 46 items were excluded, and the final model fit improved substantially with the indices were within the acceptable threshold of good or reasonably fit, cut off values are in brackets [Chi-Square statistics 1.635 (≤ 2.0), Root Mean Square Error of Approximation 0.050 (< 0.05), Standardised Root Mean Square Residual 0.059 (≤ 0.08), Comparative Fit Index 0.911 (0.90-0.94), Tucker Lewis Index 0.900 (0.90-0.94), Akaike Information Criteria 13024, Bayesian Information Criteria 13334]. Conclusion: The psychometric properties of the final model indicated the Malay language translated questionnaire is reliable and valid to investigate nurses’ perspective and involvement in end-of-life care.
ABSTRACT
Background: Pruritus is a common complication of intrathecal opioids and numerous medications have been used to prevent or treat this complication. However, the efficacy of these medications vary. The choice of medications also depends on the availability and the cost. We performed a randomised double-blind study to evaluate whether nalbuphine is as effective as chlorpheniramine, a medication that is commonly used for treating pruritus for the treatment of intrathecal opioid-induced pruritus in parturients undergoing lower-segment caesarean section. Materials and Methods: Two hundred and thirty four parturients with American Society of Anaesthesiologists (ASA) physical status I or II who had intrathecal opioid-induced pruritus were assigned to receive either intravenous nalbuphine (4 mg eight-hourly) or intravenous chlorpheniramine (5 mg eight-hourly) for a period of 24 hours. Pruritus was assessed using a qualitative scale at pre-treatment, six, nine, 12 and 24 hours post-treatment. Results: The occurrence of intrathecal opioid-induced pruritus was significantly reduced in parturients treated with intravenous nalbuphine as compared to intravenous chlorpheniramine at all intervals studied. Conclusion: In conclusion, nalbuphine is more effective than chlorpheniramine in reducing intrathecal opioid-induced pruritus for parturients undergoing lower-segment caesarean section.
Subject(s)
Pregnancy , Anesthesia , Histamine H1 Antagonists , Injections, Spinal , Analgesics, OpioidABSTRACT
Clinical decision making in nursing practice is a systematic process involves in identifying problems to ensure optimum delivery of patient care. The study aimed to examine the nurses' decision-making skill in the clinical nursing setting of a tertiary hospital. Ninety three respondents were recruited in this study using Jenkins Clinical Decision Making in Nursing Scale [CDMNS]. The four subscales of CDMS were: search for alternatives and options [mean of 25.99 +/- 3.049]; canvassing for objectives and values [mean of 27.76 +/- 31.50]; evaluation and re-evaluation of consequences [mean of 25.89 +/- 4.437] and search for information and unbiased assimilation of new information [mean of 27.54 +/- 3.939]. There were significant differences between the respondents' marital status with CDMNS subscale of canvassing for objectives and values [t=2.916, p value <.05] and respondents' satisfaction with CDMNS subscale of evaluation and reevaluation of consequences [t =2.932, p value <.05]. Significant differences existed between respondents academic qualifications with CDMNS subscale of evaluation and re-evaluation of consequences [F=6.649, p value< .05] and search for information and unbiased assimilation of new information [F = 6.0009, p value <.05]. Developing decision-making skills are essential in translating theoretical nursing knowledge to clinical practice