Virtual Learning during COVID-19 Pandemic: Pros and Cons

The current outbreak of corona virus disease (COVID-19), declared as public health emergency of national and international concern by World Health Organization (WHO), led to unprecedented public health responses in Nepal and many countries around the world including travel restriction, closure of educational institutions, curfews in some places and quarantines. This pandemic has affected lives of millions in different ways in different geographic locations worldwide. Beyond the immediate threat to health, unemployment, insecurity, etc., education is one of the sensitive areas which has been affected tremendously, students in Nepal not being an exception. The closure of all educational institutions effective from 18th March, 2020 followed by the nationwide lockdown from 24th March, 2020 till date enforced by Government of Nepal (GoN) as an effort to limit the spread of COVID-19 has shed a light on numerous issues affecting the access to education. As per the United NationsEducational, Scientific and Cultural Organization (UNESCO) report 2020, a total of 1,190,287,189learners are currently affected constituting 68% of the total enrolled learners worldwide because of temporary or indefinite country wide school closures implemented by the respective governments in an attempt to slow the spread of COVID-19. In Nepal alone 8,796,624 students have reportedly been affected

Clinical Nurses’ Knowledge and Attitude on Palliative Care: A Cross-Sectional Study

Introduction: Palliative care is a multidisciplinary approach for enhancing the quality of life of terminally ill patients. For nurses, being the core members of the palliative care team, adequate knowledge and a positive attitude are crucial. This study aimed to assess clinical nurses' knowledge and attitude on palliative care. Method: A cross-sectional descriptive study was conducted among 122 nurses. A simple random sampling technique was applied to select the sample. Internationally validated questionnaires-“The Palliative Care Quiz for Nursing” and “Frommelt Attitudes Toward Care of the Dying Scale” were used to assess knowledge and attitude. Data were analyzed using descriptive statistics and inferential statistics. Results: The mean age of participants was 25±5.42 years and a majority (70.5%) were staff nurses. None of the participants had ever received training or in-service education related to palliative care. Only 29.5% had a fair level of knowledge and, 28.7% had a good level of attitude towards palliative care. Pearson correlation test revealed a negligible correlation between the level of knowledge and attitude (r= 0.135, p=0.887). Ethnicity (p=0.02) and religion (p=0.02) were statistically significant with the level of knowledge and care for dying relatives (p=0.03) was statistically significant with the level of attitude. Conclusion: The study revealed that nurses’ have poor knowledge of palliative care but had a fair attitude. As nurses are core members, regular training and in-service education can enhance their knowledge level. Positive reinforcement, appreciation, and reward for desirable behavior can help them develop a good attitude towards palliative care

Nursing Students’ Perception of Online Learning Amidst COVID-19 Pandemic

Introduction: The declaration of COVID-19 pandemic on 11th March 2020 by World Health Organization forced many countries including Nepal to choose online mode of nursing education. Hence, it is essential for the educators to find out students’ perception that ensures their readiness to learn in this new environment. This study sought to examine the perception of online learning among nursing students. Methods: After obtaining ethical clearance, a cross-sectional descriptive study was conducted among 211 nursing students using enumerative sampling method. Self-administered structured online questionnaire was used. Calculated Cronbach's alpha value was 0.828. Descriptive (frequency, percentage, mean etc.) and inferential statistics (Chi-square test) were used to analyze data. Results: The mean age of the participants was 19.80±1.87 years. All (100%) had mobile phone. Most (93.8%) had internet facility at home. More than half (59.7%) strongly agreed that face-to-face learning was more effective. Less than half (44.6%) strongly agreed that interrupted internet connection was an obstacle. More than half (56.9%) participants had positive perception of online learning. Age, enrolled nursing program and device used were statistically significant with perception of online learning. Conclusion: The perception of nursing students towards online learning is positive. Students are satisfied with their learning opportunities amidst COVID-19 through online education. However, interrupted internet connection, unfeasible practical natured courses, load-shedding etc. were perceived as obstacles to online learning. Age, enrolled nursing program, academic year, and devices used had an impact on positive perception

Perceived Barriers to Adherence to Standard Precautions among Healthcare Personnel Working in a Teaching Hospital of Palpa District, Nepal

Introduction: The present study aimed to find out the perceived barriers to adherence to standard precautions among healthcare personnel working in a teaching hospital of Palpa district. Methods: A descriptive cross-sectional study was conducted among 191 healthcare personnel in April 2019. Barriers to standard precautions adherence were evaluated using ‘Factors Influencing Adherence to Standard Precautions Scale’. Mann Whitney U test and Kruskal Wallis H test were applied to examine the association of selected demographic variables: age, educational background, duration of employment, working areas and having attended trainings related to standard precautions with the perceived barriers to standard precautions adherence. Results: The mean age of participants was 24.87±6.05 years. Most (85.3%) of participants were nurses.  19.9% and 52.4% of participants always performed hand hygiene before and after using personal protective equipment respectively. The subscale scores in leadership and culture of the institute were 14.86±4.21 (possible range 0-24) and 14.59±2.60 (possible range 0-20) respectively. Subscale scores in judgement and contextual cues were 17.49±3.46 (possible range 0-20) and 18.02±5 (possible range 0-24) respectively. Score in justification was 7.52±5.12 (possible range 0-28). Age, educational background and duration of employment had a statistically significant association with subscale scores on justification and perceived culture of the institution. Conclusion: The present study revealed that only 19.9% of the participants would perform hand hygiene before using gloves and 52.4% of participants would do it afterwards. Personal judgement, dependence on contextual cues and inadequate leadership skills were found to be the major barriers to adherence to standard precautions

BURDEN IMPOSED BY DIABETES MELLITUS ON ELDERLY PATIENTS VISITING A TEACHING HOSPITAL

Introduction: Diabetes Mellitus (DM), a chronic metabolic disorder, has become an alarmingly a major health issue worldwide. Thus, the study aimed to assess the burden imposed by diabetes mellitus on elderly patients visiting Lumbini Medical College and Teaching Hospital (LMCTH). Methods: A descriptive cross-sectional study was conducted among 178 diabetic elderlies purposively visiting medicine out-patient department of LMCTH. Elderly Diabetes Burden Scale was used to assess the burden imposed by diabetes. Results: The mean(SD) age of the participants was 67.38(6.92) years, more than half(52.2%) were male, 46.6% were janajati and 77.5% were from Palpa district. Most(84.3%) had diabetes for duration of 1 to 10 years, 45.6% had normal body mass index(BMI), 47.2% had good glycaemic control (HbA1C <7%), and  74.2% were on oral hypo-glycaemic agents. Dietary restrictions (10.32±2.97) and worry about diabetes (10.30±2.85) were perceived as high burden level and burden by tablets/insulin (7.02±2.12) as lower burden amongst the six domains. Age, education and body mass index (BMI) were found to be highly statistically significant with the treatment dissatisfaction domain (p<0.001). Likewise, duration of diabetes (p=<0.001) with burden by tablets/insulin and symptom burden domain. Conclusion: Dietary restrictions and worry about diabetes were found to have dominant burden whereas, burden by tablets or insulin was the least. Duration of diabetes and body mass index (BMI) were found to have association with the overall burden. Likewise, age, education and BMI seems to have high influence on the perception of burden due to treatment dissatisfaction