Nurses' perception of barriers and facilitates of research utilization in the clinical setting

Many nurses are now using the term evidence based practice [EBP], but trying to actualize or implement EBP in clinical area is still an issue of great concern for the nursing profession. Identification of barriers and facilitators is useful potentially to overcome barriers and enforce facilitators and this could ultimately improve nursing practice. During the past three decades different models of research utilization and quality improvement have often been employed as vehicles for implementing new knowledge and development in health care. If a research based practice is desired, research must be an integrated part of the clinician's ideas, rules and understanding. In Egypt, however the presence of research principles and statistics in the nursing curricula with the aim to prepare nurses for these roles, little is known of nurses' perceptions regarding their research training and their use of research findings, once they are graduated. The aim of this study was to analyse the nurse's perception of barriers and facilitators of nurses' use of research utilization in the clinical setting. A survey of all nurses in different departments of Menoufia University Hospital. One hundred nurses met the study criteria were selected. The barriers scale was used to fulfil the purpose of this study. The study nurses' demographic data were collected. The greatest barriers as perceived by nurses were the nurse does not feel she/he has enough authority to change patient care procedures; statistical analyses are not understandable, facilities are inadequate for implementation. The most frequently mentioned facilitators were improving research knowledge through training, provide fund for research activities; provide enough time, sufficient staffing and increase support from colleagues. The findings suggested that there is a need for education to increase nurses' awareness of the knowledge and skills of research utilization. The nursing research that covers the clinical area must be presented in a clear and understandable way as well as the statistical analyses must be clearly presented. It is also suggested that nurse clinicians and nursing researcher should be brought closer to each other. There is a need to the presence of nursing researcher in the clinical setting to support and facilitate research utilization. Also the findings emphasized the importance of including both individual and organizational factors in strategic planning for research utilization

Impact of non-pharmacological therapy on the physical and psychosocial status of women who develop lymphedema after mastectomy

The present study was designed to Investigate the impact of education and training non-pharmacological therapy on physical and psychological status in women who develop post mastectomy arm lymphedema. This study was conducted at Menoufyia University Hospital and Menoufyia Oncology Center. Forty post mastectomy patients who met the study criteria were selected. Patients were randomly assigned to two equal groups, an intervention and control group of 20 patients each. The intervention group were taught self-nonpharmacological management that included self-massage, pressure bandage, elevation, arm exercise, skin care and hygiene and safety precautions to prevent injury to the affected limb for 3 sessions a week for two weeks. In addition to the patients was instructed to practice it in comfort at home, while the control group received the hospital routine lymphedema management. Both groups, the intervention and control groups were interviewed and their arm circumferences were measured four times throughout the study, baseline before intervention, 1 months, 6 months and 9 months after intervention. The arm problem questionnaire and state anxiety were assessed two times, before the intervention and at the last assessment. Patient's medical record was reviewed for medical history. The results showed education and training of lymphedema management protocol had effective arm lymphedema control and improved arm function, physical, and psychological status [7=2.45; P=.024, t-29.47; P - .001, t=10.91; p=.001] when compared with those who followed the hospital therapy. The intervention group reported improved arm function after the intervention as compared to control group. It is concluded that education and training lymphedema management was an effective nursing intervention for controlling arm lymphedema and improved physical and psychological status of women with post mastectomy arm lymphedema. It is recommended that the women with post mastectomy arm lymphedema should be encouraged to practice self- lymphedema management to promote lymph drainage since the pharmacological intervention remains uncertain

Determining health related quality of life, post-traumatic anxiety and depression among orthopaedic patients with traffic injury

The aims of this study were to investigate and follow up the patient condition after accident, estimate the incidence of delayed recovery; identify predictors of non recovery 6 months after accident and examine the relationships between stress, anxiety and quality of life after traffic accident. The design of this study was descriptive correlarional research. This study was conducted at Emergency Unit and Orthopedic Departments at Menoufiya University Hospital and Shebine El-Kome Teaching Hospital. A convenient sample of 100 patients with traffic injury was recruited for the study. Inclusion criteria included all the patients aged 18-70 and living in Menoufiya city, mentally unimpaired and eligible to participate in this study. Six tools were used to collect data. The tools included: structured questionnaire used to assess the socio-demo graphic and medical history; New Injury Severity scores [NISS] used to assess the severity of physical injury; the State Anxiety Inventory [SAI] used to measure and evaluate current feeling of anxiety; Beck Depression Inventory [BDI] asks about feelings and behaviour; The Short form 36 of the Medical Outcomes Questionnaire [SF-36] used to measure quality of life; and Medical Records. Results yielded by this study indicated that a large proportion of orthopaedic patients experienced depression, anxiety, physical and psychological disabilities at week one, which correlated with decreased quality of life. About 31 and 34% of the patients reported still suffering from physical and psychological impairments and disabilities that affected their daily life. Risk factors found to correlate with poor health related quality of life were: Depression, anxiety, physical disability and psychological disability that should be taken into consideration for active intervention. Recommendations include: the return of orthopaedic patients trauma survivors to pre-injury quality of life will depend on commitment to long range trauma care, quality of life, awareness of psychiatric abnormality and rehabilitative and support services; The orthopaedic trauma patients need adequate information during care, sufficient pain management and that at discharge the need frequent follow up; Nurses working in emergency and orthopaedic departments needs to include assessment of depression, anxiety, physical disability, psychological disability, quality of life in patient assessment because early identification of these disorders may decrease the likelihood of these conditions affecting long term quality of life negatively. Also the known risk factors can assist nurses in identifying patients that are in need of additional help and support during care and after discharge from acute care hospitals; Additional studies are needed to increase the follow up time to include 9 months and one year assessment after injury

Determining prevalence of injury, Injury outcomes and first aid among patients in Menoufyia Hospitals

The aim of the current study was to determine the prevalence of injury, injury outcomes, first aid given and to examine the relationship between the injury outcome and first aid given, and hospital stays. The study was conducted in emergency units and inpatient departments at Menoufyia University Hospital and Shebine El-Kome Teaching Hospital. A convenient sample of 1000 patients who met the study criteria were selected. The data were collected by questionnaire and reviewing patient medical record. The results yielded by this study indicated a high prevalence of injury. The main causes of theses injuries were vehicle crash, fall down, and burn. Most injuries occurred at home and road and injury resulted in disabled people [11.8%], and died people [12.8] This study also revealed that a significant relationship between injury outcomes, hospital stay and first aid. We recommend that developing and disseminating educational material about first aid to the patients to rise and upgrade the awareness of first aid and home and road injury. First aid training must become a compulsory, rather than an optional, component of the school and university curriculum. It is important to educate the employee in their work place during the working hours. Conducting mass media campaigns to motivate general public to recognize and seek first aid information. Further studies are needed to determine the effectiveness of training strategy and any resultant change in community behavior

Impact of nurse counseling on non-pharmacological treatment on the control of hypertension in Menoufyia Hospitals

The present study was designed with the aim to assess whether a non-pharmacological treatment [also termed "lifestyle modification"] program implemented by nurse in the hospital setting would improve blood pressure control in treated hypertensive patients. This study was conducted at Menoufyia University Hospital and Shebin El-Kome Teaching Hospital. Sixty hypertensive patients who met the study criteria were selected. Patients were randomly assigned to two equal groups, an experimental and a control group of 30 patients each. The experimental group was provided with verbal and written instructions about lifestyle modification through face to face counseling and monthly telephone call to remind them about the main instruction, while the control group was provided with only lifestyle modification written instruction. Data were collected by developed questionnaire, blood pressure [BP] measurements were obtained by the authors who used zero sphygmomanometer, weight was measured using a calibrated scale, and height was measured using a wall-mounted stadiometer. Each of these measurements was obtained 3 times, one baseline measure before intervention, and two times, at 3 and 6 months after intervention. Results Showed significant improvement in the lifestyle modification as well as in BP reduction among experimental group. It is recommended that all hypertensive patients should be encouraged to adhere to the non-pharmacological treatments since they are safe, inexpensive, and when combined with drug therapy may result in better BP reduction. Further study is needed to assess and train nurses about non-pharmacological treatment