Effectiveness of exercises on pain and sleep among patients with diabetic peripheral neuropathy in selected hospitals at Erode

Diabetes is a chronic condition that occurs when the pancreas does not produce enough insulin or the body cannot effectively use the insulin it produced by hyperglycemia and other related disorders in the body’s metabolism can lead to serious damage to many of the body systems especially of nerves and blood vessels. Diabetic complications are classified in to two major categories like acute and chronic. The acute complications of diabetes include diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, hypoglycemia. The chronic complications of diabetes again classified in to micro vascular and macro vascular complications. The micro vascular complications include diabetic retinopathy, diabetic nephropathy, diabetic neuropathy. Macro vascular complications are stroke, hypertension, insulin resistance syndrome. Diabetic peripheral neuropathy is nerve damage that occurs because of the metabolic degenerations associated with diabetes mellitus. The most common symptoms of diabetic peripheral neuropathy include pain, burning, tingling, or numbness in the toes or feet, and extreme sensitivity to light touch. The pain may be worst at rest and improve with activity, such as walking. Some people initially have intensely painful feet while others have few or no symptoms. Diabetic peripheral neuropathy usually affects both sides of the body. Diabetic peripheral neuropathy treated with main three components that is , tight control of blood sugar levels , care for the feet to prevent complications and Control of pain caused by neuropathy. Diabetic patients are encouraged to follow a daily leg exercises , foot care regimens like washing , and inspecting the foot proper fitting shoes can prevent major complications. A study was done to evaluate the effectiveness of exercises on pain and sleep among patients with diabetic peripheral neuropathy in selected hospitals, Erode. An Evaluative approach was used for this study. The research design used was Quasi experimental non equivalent pre test and post test control group design. The conceptual framework of the study was based on the “Modified Ludwig Von Bertlanffy System theory (1968). Non probability purposive sampling method was used to select 60 samples for the study. 30 samples were in experimental group was selected from S.R.C diabetes care centre Erode and 30 samples were in control group was selected from Monika diabetes care centre Erode. The tool used for this study was Leeds Assessment of Neuropathic Signs and Symptoms Scale to assess the level of pain and Sleep Scale from medical outcome of study to assess the level of sleep, exercises was given to the patients with diabetic peripheral neuropathy for 30 minutes once in a day for a period of 15 days in experimental group. The data gathered were analyzed by using descriptive and inferential statistics. The mean post test level of pain in experimental group 9.6(SD±3.15) was significantly lower than the mean posttest level of pain in control group 15.9(SD±2.99) The mean difference was 6.3.The Independent‘t’ value was 8.51which was significant at p<0.05 level. The mean post test scores of sleep in experimental group 47.7 (SD±5.56) was significantly higher than the mean post test scores of sleep in control group 34.2(SD±7.03). The mean difference was 13.5.The independent‘t’ value was 8.88which was significant at p<0.05 level. The mean post test scores of pain and sleep among patients with diabetic peripheral neuropathy in experimental group were 9.6(SD±3.15) and 47.7 (SD±5.56) respectively. The mean difference was 38.1. The ‘r’ value was -0.9 which showed that negative relationship between pain and sleep scores among patients with diabetic peripheral neuropathy in experimental group. It reveals that as the pain level decreases sleep pattern was improved. The study findings revealed that there was a significant association between post test level of pain among patients with diabetic peripheral neuropathy with demographic variables of marital status(χ2=7.74), family monthly income(χ2=9.65), and duration of treatment for diabetic peripheral neuropathy(χ2=7.66) at p<0.05 level of significance and no significant association between post test level of sleep score in experimental group. There is a decreased level of pain and improvement in the level of sleep pattern among patients with diabetic peripheral neuropathy after exercises. The study findings revealed that practicing exercises is beneficial for patients with diabetic peripheral neuropathy for decreasing pain and improving sleep pattern

Proceeding: 3rd Java International Nursing Conference 2015 “Harmony of Caring and Healing Inquiry for Holistic Nursing Practice; Enhancing Quality of Care”, Semarang, 20-21 August 2015

This is the proceeding of the 3rd Java International Nursing Conference 2015 organized by School of Nursing, Faculty of Medicine, Diponegoro University, in collaboration with STIKES Kendal. The conference was held on 20-21 August 2015 in Semarang, Indonesia. The conference aims to enable educators, students, practitioners and researchers from nursing, medicine, midwifery and other health sciences to disseminate and discuss evidence of nursing education, research, and practices to improve the quality of care. This conference also provides participants opportunities to develop their professional networks, learn from other colleagues and meet leading personalities in nursing and health sciences. The 3rd JINC 2015 was comprised of keynote lectures and concurrent submitted oral presentations and poster sessions. The following themes have been chosen to be the focus of the conference: (a) Multicenter Science: Physiology, Biology, Chemistry, etc. in Holistic Nursing Practice, (b) Complementary Therapy in Nursing and Complementary, Alternative Medicine: Alternative Medicine (Herbal Medicine), Complementary Therapy (Cupping, Acupuncture, Yoga, Aromatherapy, Music Therapy, etc.), (c) Application of Inter-professional Collaboration and Education: Education Development in Holistic Nursing, Competencies of Holistic Nursing, Learning Methods and Assessments, and (d) Application of Holistic Nursing: Leadership & Management, Entrepreneurship in Holistic Nursing, Application of Holistic Nursing in Clinical and Community Settings

The Educational Needs of Home-Based Stroke Patients and Family Caregivers in Malaysia

Many research studies have been done in relation to the educational needs of patients and families post-stroke based in Western countries but limited studies have been conducted in non-Western countries. This study explored the educational needs of home-based stroke patients (HBSP) and family caregivers in the Kelantan state located at the northern part of Peninsular Malaysia. The other areas of focus were to identify the resources available for HBSP and their families, the practice of health professionals in relation to the provision of information and education and the early rehabilitation needs for HBSP and family caregivers. A further aim was to develop education strategies that will help patients and their families to minimise risk of complication post-stroke and support the advancement of their quality of life. This study used a qualitative approach guided by a theoretical framework "Stroke Care Community Model (SCCM)" developed for this research. This study was in two phases. Phase 1 involved semi-structured interviews with three kinds of participants: stroke patients (n=5), family caregivers (n= 5) and key members from health professional groups (n=12). Phase 1 established the educational activities currently received and needed by patients and families. Phase 2 involved presenting the findings from Phase 1 to the previously interviewed health professionals through focus groups and individual interviews with the aim of establishing priorities and processes to develop education strategies for HBSP and their families. The findings revealed that the provision of information and education does not meet the needs of many patients and families. There is no national or local programme provided to address patients' and families' needs. The educational needs are on a wide range of topics including the nature and the impacts of stroke, how and why stroke happens, how to prevent stroke recurring, prevention of complications and promoting faster recovery. The need for skills on managing patients at home include positioning, strengthening, mobilisation, prevention of complications, feeding, swallowing, managing co-morbid conditions, basic exercise and safety. The findings also revealed some needs are religiously and culturally bound around prayer and traditional healthcare practice such as urutan tradisional (traditional massage). Prayer and reciting Holy Qur'an are part of cognitive training, coping strategies, rehabilitation therapy and a source of psychological support. Therefore, there is a need to take the knowledge of what makes a difference to health outcomes of patients and families in a western context and work with this, utilising what is important in the culture of people at a local level. The next step to progress addressing educational needs requires a structured approach involving the formation of a multi-disciplinary stroke team that incorporates cultural and religious practice

The experience of zen meditation on patients with generalized anxiety disorder in Taiwan

This study explored the experience of patients with generalized anxiety disorder (GAD) undertaking a six week intervention of a Zen meditation programme in Taiwan. Mix-methods were used including the Revised State and Trait Anxiety Inventory (RSTAI), repeated focus groups, individual interviews, diaries and field notes. Heidegger’s interpretative phenomenology was adopted as a theoretical framework. Two groups of 9 and 12 patients (n=21) participated in the study. Three themes emerged from repeated focus groups: First ‘Expectation of Zen meditation regarding GAD symptoms included sub themes of ‘ambivalence towards meditation’, ‘crave a good sleep’, ‘stop thinking’ and ‘regain memory and concentration’. The second theme, ‘The process of Zen meditation’ included the sub themes of ‘struggling to reach a state of calm’, ‘signs of improvement’ and ‘an individual process’. The last theme, ‘The cultural beliefs regarding Zen meditation in Taiwan’ involved the ‘spiritual influence’ of Zen meditation practice. Four themes emerged from individual interviews. Firstly, ‘Separation’ referred to the issues that participants faced in dealing with the termination of the programme, including ‘concern about other participants’ and ‘examining the relationship between Zen meditation and self’. The second theme ‘Body experience of Zen meditation practice’ incorporated ‘body awareness’ and ‘preparing to practise Zen meditation’. The third theme, ‘States of mind while meditating’ consisted of ‘the state of engagement with real life’, ‘the state of detachment from real life’ and ‘the state of calm’. Lastly, ‘Benefits of Zen meditation practice’ incorporated the categories ‘less pressure with daily life’ and ‘more acceptance of being a GAD patient’. The RSTAI was administrated at baseline and post intervention and also at the two week follow-up of the Zen meditation programme. Neither the Trait Anxiety Score nor the State Anxiety Score showed significant differences between Groups 1 and 2 at baseline. This allowed the RSTAI data from the 2 groups to be merged.The results of 95% confidence interval for differences of both groups showed a significant improvement in the Trait Anxiety Score over time but not the State Anxiety Score. This study contributes to the existing body of knowledge and associated literature regarding Zen meditation and GAD in three ways. Firstly, the findings confirmed that the essential or authentic traditional qualities of meditation should be addressed in meditation study. Secondly, the meaning of Zen meditation for the groups of GAD patients was revealed in the context of Taiwan society. How their lived experience of GAD shaped their understanding of Zen meditation was interpreted. Thirdly, a comprehensive understanding of Zen meditation is reported. The findings (including themes, i.e. diverse Zen meditation processes, body experiences, concepts of obstacles and spiritual influence) add to the current knowledge by providing insight derived from participants’ lived experiences