The Effectiveness of Music Therapy for Post-Operative Pain Control among Total Knee Replacement Patients

Pain is an unpleasant sensation that can cause physical and psychological problems for the patient. Despite the pharmacological intervention for reducing pain, it remains as an issue after surgery. Music therapy as non-pharmacological intervention can effect post-operative pain and patients’ requirement of analgesics. The purpose of this study was to determine effect of music therapy on pain after elective total knee replacement (TKR) surgery. This study compared analgesics consumption by patients post-operatively for five days. A Quasi-experimental design with convenience sample of patient with a mean of 64.35 (49-76) who underwent TKR in UKM Medical Centre from May to December 2012 was used. Forty patients were randomly assigned in one of the two groups using a sealed-envelope technique. The experimental group listened to music for five days post-operatively and were on analgesics and control group were treated with pharmacological intervention only. Pain was measured by McGill Pain Questionnaire-Short Form (MPQ-SF) for patient on bed rest on day one, day three and day five post-operatively. Statistical (Mann- Whitney) findings between groups showed the experimental group significantly had less pain on day one and day five rather than the control group at 0.05 level using Pain Rating Intensity (PRI), Visual Analogue Scale (VAS) and Present Pain Intensity (PPI). Statistical (Friedman) tests within group showed that the patient had significantly decreased pain over time at level 0.05 using PRI, VAS and PPI. Statistical (Mann- Whitney) tests revealed that there was no significant difference when using analgesics between the two groups in five days post-operatively at milligram but comparing median showed experimental group used less analgesic than control group. Music therapy is simple, available, save and cheap effective intervention for pain management post-operatively. Pain management is one of the key roles of nursing and nurses can use music therapy as a simple intervention to reduce pain.

Workplace Violence Experienced by Nurses in Universiti Kebangsaan Malaysia Medical Centre

Lately, increasing workplace violence is a problem that requires serious attention by the management of the healthcare sector. This study was carried out to examine workplace violence experienced by nurses in the Universiti Kebangsaan Malaysia Medical Centre. It aimed to identify the category of nursing staff who formed the highest number of victims, the perpetrators and the common types of workplace violence. This was a descriptive cross-sectional study carried out over a three month period on 55 nurses who had participated voluntarily in this study. The demographic data and data on the violent incident were collected by using a 21-item questionnaire. The reliability and validity with Cronbach’s alpha was 0.872. Information on the most common types of violence, victims and the perpetrators was also collected. The study revealed that workplace violence among the nursing staff was 3.7% with an average of 1.2% being abused per month and one nurse being abused every other day. The study also revealed that the staff nurses were the most common victims and the perpetrators were mainly the patients (40.6%) and the patients’ relatives (37.5%). The most common forms of violence were verbal abuse (31.9%) and verbal threat (23.7%). Physical violence was experienced by 44.4% of the victims. These results suggest that workplace violence is a serious problem which should be addressed in order to create a safe environment for the nurses.

Prevalence of Stress and Coping Mechanism among Staff Nurses in the Intensive Care Unit

The working environment of intensive care unit (ICU) nurses is a constant source of stress. Researchers have described ICU as a stressful environment because of the complex nature of patients’ health problems requiring an extensive use of very sophisticated technology. This study aimed to identify the prevalence of stress among staff nurses working in ICU, Hospital Universiti Kebangsaan Malaysia (HUKM), factors influencing stress and to explore the symptoms of stress experienced. This descriptive study was conducted on 67 staff nurses working in ICU, HUKM. Data was collected using selfadministered questionnaires. The questionnaires included sections on socio-demographic data, factors influencing stress and symptoms of stress experienced. Data was analysed using frequency and percentage. The Chi square test was used to examine the relationship between socio-demographic data and factors influencing stress. Findings indicated that stress symptoms were experienced by 100 per cent (n =67) of staff nurses. Knowledge, working experience, critically ill patients, and environmental factors were one of the many factors contributing to the stress experienced by the ICU nurses in HUKM. Nurses working in ICU, HUKM are found to have a high level of stress. Recommendations like encouraging ICU nurses to take up post basic ICU courses and increasing the nurses quota can reduce the prevalence of stress among ICU nurses. Hospital management has an important role to play in reducing the stress levels of nurses working in ICU as stress has an effect on job performance and quality of nursing care.

Sharps Injury in Hospital Universiti Kebangsaan Malaysia (HUKM): Experiences of Health Care Workers and Students

Sharps injury among health care workers in HUKM has received serious attention lately due to the possible transmission of diseases like HIV, Hepatits B and Hepatitis C, which can cause serious consequences for the victim. The aim of the study was to gain a deeper understanding of the emotional problems experienced by health care workers who had incurred a sharps injury and the coping strategies adopted by them to overcome the problem. A 28 item semi-structured questionnaire was designed by the supervisors and the researcher as there was no existing questionnaire to be adopted, as no research had been carried out in this area prior to this. The target group consisted of 64 health care workers of different categories working in HUKM. Data was collected over a period of five months from November 2000 to March 2001. The results of the study revealed that the most frequently injured were the staff nurses, nearly 90% of whom were emotionally upset and were worried that they might contract a disease. There was no significant difference in the emotional stress experienced by the different categories of the health care workers, all were equally upset about the injury but each category of staff adopted different methods to overcome the tragedy. Open comments and opinions about prevention and the management of the sharps injury in HUKM as given by the respondents here are taken into account. Several views given by the participants were explored and discussed. Finally, several implications for nursing and recommendations have been presented.