Comparision of Quality of Life of Senior Citizens Residing in Old Age Homes and Own Residence.

BACKGROUND: Quality of life of elderly is becoming even more relevant with demographic shift happening towards an ageing society. With fast changing family condition and social contexts, lives of elderly people in Nepal have been changing dramatically. Old age homes have sprung up to cater to the needs of the elderly from different socio-economic backgrounds. The objective of this study is to compare the quality of life of senior citizens of selected old age homes and own residence and to find the association of quality of life with selected study variables. METHODS: A comparative study was conducted among 120 senior citizens from Dhankuta, Morang and Sunsari districts of Koshi zone. Two strata were formed based on their residence, i.e., old age homes and own residence. Equal proportion of the samples were selected from both the settings. Data was collected using interview schedule through pretested semi-structured and standard World Helth Organization, quality of life - old questionnaires. RESULTS: More than one fifth (23.33%) of research participants were from the age group 65-69 and 75-79 and more than half (55%) of them were female. More than half (58.33%) of the research participants residing in their own residence had high quality of life level, while among those residing in the old age homes, only about 40% had high quality of life level. Quality of life level was found to be significantly associated with sex and educational status of the research participants. CONCLUSIONS: Quality of life was found to be better among the people residing in their own residence as compared to those residing in old age homes.

Availability of Life Support Equipment and its Utilization by Ambulance Drivers.

BACKGROUND: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. METHODS: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method. Self- constructed observation checklist and semi structured interview schedule was used for data collection. RESULTS: More than half of the respondents had less than five years of experience and were not trained in first aid. About two-third of the respondents had adequate knowledge on first aid. About 90% of the ambulance had oxygen cylinder and adult oxygen mask which was 'usually' used equipment. More than half of ambulance had equipment less than 23% as compared to that of national guidelines. There was significant association of knowledge with the experience (p = 0.004) and training (p = 0.001). Availability of equipment was associated with training received (p = 0.007),organization (p= 0.032)and district (p = 0.023) in which the ambulance is registered. CONCLUSIONS: The study concludes that maximum ambulance linked to BPKIHS, Nepal did not have even one fourth of the equipment for basic life support. Equipment usually used was oxygen cylinder and oxygen mask. Majority of driver had adequate knowledge on first aid and it was associated with training and experience.

Development and evaluation of a newborn care education programme in primiparous mothers in Nepal.

BACKGROUND: the health and survival of newborns depend on high levels of attention and care from caregivers. The growth and development of some infants are unhealthy because of their mother's or caregiver's lack of knowledge or the use of inappropriate or traditional child-rearing practices that may be harmful. OBJECTIVE: to develop a newborn care educational programme and evaluate its impact on infant and maternal health in Nepal. DESIGN: a randomised controlled trial. PARTICIPANTS: one hundred and forty-three mothers were randomly assigned to the intervention (n=69) and control (n=74) groups. Eligible participants were primiparous mothers who had given birth to a single, full-term, healthy infant, and were without a history of obstetric, medical, or psychological problems. METHODS: prior to being discharged from the postnatal unit, the intervention group received our structured newborn care education programme, which consisted of one-on-one educational sessions lasting 10-15minutes each and one postpartum follow-up telephone support within two weeks after discharge, in addition to the hospital's routine general newborn care education. The control group received only the regular general newborn care education. Outcomes were measured by using Newborn care Knowledge Questionnaires, Karitane Parenting Confidence Scale, State-Trait Anxiety Inventory for Adults and infant health and care status. FINDINGS: the number of mothers attending the health centre due to the sickness of their babies was significantly decreased in the intervention group compared to the control group. Moreover, the intervention group had significant increases in newborn care knowledge and confidence, and decreases in anxiety, compared with the control group. CONCLUSIONS: the structured newborn care education programme enhanced the infant and mother health. Moreover, it increased maternal knowledge of newborn care and maternal confidence; and reduced anxiety in primiparous mothers. Thus, this educational programme could be integrated into routine educational programs to promote maternal and infant well-being in Nepalese society.

Translation and validation of the Karitane Parenting Confidence Scale in Nepali language.

BACKGROUND: a mother׳s lack of confidence in the early postnatal period may negatively influence their ability to care for their infant. Parenting confidence contributes to the parent-infant relationship and other aspects of infant development. The Karitane Parenting Confidence Scale is a 15-item self-report questionnaire designed to measure parents' subjective confidence in their parenting abilities, or 'perceived parenting self-efficacy', and is designed for mothers with infants aged 0-12 months. OBJECTIVES: to translate the Karitane Parenting Confidence Scale into Nepali language and assess the validity and reliability among Nepalese postnatal mothers. DESIGN: cross-sectional study. SETTING: outpatient department of maternity and women׳s hospital in Kathmandu, Nepal. PARTICIPANTS: one hundred postnatal mothers within 5-6 weeks of childbirth were recruited using the convenience sampling method. METHODS: following back-translation procedures, mothers completed questionnaires during follow-up visit at immunisation/postnatal clinics. For the validity and reliability have been assessed internal consistency, discriminant validity, and construct validity. RESULTS: the translated Karitane Parenting Confidence Scale mean score was 35.47±5.48, ranging from 32 to 42. Cronbach׳s alpha coefficient for internal consistency was 0.87. A difference was found between primiparous and multiparous mothers׳ confidence scores. There was a significant correlation between maternal confidence and anxiety scores. Demographic response patterns suggest that the maternal confidence level was affected by education level. CONCLUSIONS: the Nepali version of Karitane Parenting Confidence Scale showed adequate reliability and validity. Therefore, the Nepali Karitane Parenting Confidence Scale is considered a suitable instrument to assess maternal confidence in Nepali postnatal mothers.

Nepalese primiparous mothers' knowledge of newborn care.

A cross-sectional study was carried out to explore the knowledge level of newborn care and to investigate the relationship between newborn-care knowledge and selected demographic variables among primiparous mothers. It was carried in outpatient department of a maternity and women's hospital in Kathmandu, Nepal with 276 primiparous mothers between 38 and 42 weeks of gestation. Data were collected during the antenatal period with using two instruments: the Newborn-care Knowledge Questionnaire and State-Trait Anxiety Inventory for Adults. Participants had a moderate level of knowledge on newborn care (56%), and among its four components, participants had lowest knowledge in breastfeeding (44%) and adequate knowledge (78%) of immunization. Maternal education and socioeconomic status had a significant, positive association with newborn-care knowledge. Newborn-care knowledge was strongly predicted by anxiety. This is the first study to examine the maternal levels of knowledge of newborn care in Nepal. This study identified specific knowledge gaps in newborn care among primiparous mothers. Moreover, the results suggest the need of maternal-education programs in improving the health and well-being of mothers and newborns.