Discharge Education for Mild Traumatic Brain Injury Patients at Emergency Department

This study aims to review the literature on educational interventions for the discharge of mild traumatic brain injury (mTBI) patients in the Emergency Room (IGD). Database searches were performed based on PICO queries and keywords. using ProQuest, ScienceDirect, Scopus, and PubMed for the period 2012-2019. Ten studies were reviewed. The findings revealed the contents of discharge information for mTBI patients including diagnosis, signs and symptoms, treatment and medication, pain management, home care, and ED return instructions. Four methods of discharge intervention are commonly used in the ED; written, spoken, animated and moving videos, and printed instructions measured over two time periods, either pre-discharge in the ED or follow-up 1-2 weeks post-discharge at home. In conclusion, combined teaching was more effective in terms of level of knowledge, understanding, and ED repeat visits.   Keywords: Discharge education, Emergency, Minor Traumatic Brain Injur

Relationships Between Triage Knowledge, Training, Working Experiences and Triage Skills Among Emergency Nurses in East Java, Indonesia

Background: Since there are increased numbers of clients with traumatic injuries and non-traumatic cases in the emergency department in Indonesia, triage skill is an essential competency required for the emergency nurses.Purposes: This study aimed to examine the level of perceived triage skills and the relationship between knowledge, training, working experience and perceived triage skills among emergency nurses.Method: Two hundred and sixty six emergency room (ER) nurses working in two secondary and two tertiary public hospitals in East Java Province, Indonesia, were recruited by purposive sampling. Data were collected using a set of questionnaires which included the Demographic Data including training and working experiences, Triage Knowledge Questionnaire (TKQ) and Triage Skill Questionnaire (TSQ). The contents of questionnaires were validated by three experts and tested for reliability. The correlation coefficient for the TKQ was 0.99 and Cronbach\u27s alpha coefficient of the TSQ was 0.93. The collected data were analyzed using descriptive statistics including Pearson\u27s product-moment correlation to examine the relationship.Result: The results showed that the majority of subjects were female (71.4%) with aged of 22 – 40 years (79.3%), educated to diploma level (94.4%). All subjects had attended Basic Life Support (BLS) and Advanced Life Support (ACLS), and about half of them had greater than 5 years working experiences in ED. Overall perceived triage skill was at a moderate level with the mean score of 75.12 (SD = 11.23). There were significantly positive correlations between triage skill and working experience (r = .27, p < .01), training experience (r = .37, p < .01), and triage knowledge (r = .38, p < .01).Conclusion: The findings provide a better understanding of triage skills among ER nurses and suggest that the continuing education and training courses related to triage and advanced management of medical emergencies for ER nurses are required in order to increase and update the triage skills in enhancing the quality of emergency care and patient safety

Effect of Self-Efficacy Enhancing Education Program on Family Caregivers\u27 Competencies in Caring for Patients with Mild Traumatic Brain Injury in YOGYAKARTA, Indonesia

Purpose: This study was conducted to examine the effect of a self-efficacy enhancing education program on family caregivers\u27 competencies regarding perceived confidence and performance in caring for patients with mild TBI in Yogyakarta, Indonesia. Methods: The quasi-experimental study, two groups pre-test and post-test design was conducted. Fifty family caregivers and patients with mild TBI who met the inclusion criteria were recruited. The first 25 control group received the routine care were, while another 25 subjects in the experimental group received a self-efficacy enhancing education program developed by the researchers. The program was constructed using Bandura\u27s four sources of self-efficacy. The family caregivers\u27 perceived confidence and performance were measured by using the Perceived Confidence Questionnaire (PCQ) and the Performance Questionnaire (PQ). The data were analyzed using paired t-test, independent t-test, Wilcoxon Signed Rank test, and Mann-Whitney U test. Results: The findings showed that the family caregivers who participated in the program had a higher in perceived confidence (t = 8.30, p < .05) and performance (U = .00, p < .05) in caring for patients with mild TBI upon the completion of the program. Conclusion: This study suggests the program may have contributed in improving the family caregivers\u27 competencies regarding perceived confidence and also influencing their performance in caring for patients with mild TBI. Therefore, this program is recommended for nurses to extend this knowledge for nursing practices and improve family caregivers\u27 competencies in caring for patients with mild TBI before and after discharge

Quality of Life (QoL) in Patients with Traumatic Brain Injury (TBI): a Literature Review

Purpose: To describe the definition of quality of life (QoL) and identify the most appropriate tool for QoL assessment used in patients with TBI.Method: Searching was conducted from PubMed, CINAHL, EBSCO, and ProQuest during 2000-2011. A total of 33 studies were analyzed for this review consisting of 9 review studies, 2 intervention studies, and 22 descriptive studies.Result: Two important definitions of QoL were used in studies related to TBI namely achievement and subjective well-being. Although varieties of generic measurements have been used to measure QoL in TBI patients, there was a lack of TBI-specific Health-related Quality of Life (HRQoL) instrument. Despite the different approach and time measured either short or long outcomes, appropriate domains of QoL tool seem essential particularly among those with moderate and severe TBI.Conclusion: QoL is a wide concept which can be defined in several dimensions. The QOLIBRI as a new disease-specific QoL measurement in TBI seems a feasible and valid approach for the assessment of QoL in TBI. However, the application across cultural remains a challenge and needs a validation

“Bai Lod” holistic health experienced by homebound older people in the southern Thai community

Objectives This qualitative descriptive study aims to explore the meanings of holistic health in the southern Thai culture experienced by homebound older people. Background The ageing society necessitates many services to meet the holistic needs of older people. Homebound older people are commonly an understudied population who may view their holistic health and well-being differently from others. Due to geographical differences and local Thai cultural context, exploring the holistic health in the southern Thai culture would help promote a healthy lifestyle and improve their health outcomes. Methods Based on purposeful sampling, 16 key informants who were homebound older people (ages ≥ 60 years old) living at home in a rural southern Thai community were participated in semi-structured interviews. Informants consisted of six males and ten females who were Buddhist and married. Their ages ranged from 79 to 99, including nine homebound older people who lived in a couple, and seven widows and widowers. Eight had completed the primary school, and others were uneducated. The data were analysed with a content analysis. Results Most of the informants had chronic diseases. In a broad main theme, the informants described the holistic health in local context as ‘Bai Lod; which means being alive with positive, active and independent functioning. This theme included three sub-themes: self-supporting or taking care of themselves, having the ability to control their health conditions and being proud as a healthy older adult. The older people described self-supporting as the ability to perform their activities of daily living, take care of their own health and work independently (active living). Having the ability to control their health conditions meant functioning well physically, although being frail, by maintaining their health through self-management, and having a good mental health during such a life-changing situation. Older people valued the ability to live by themselves without being a burden to their family. They felt happy with their life. Conclusion Holistic health was described as being positive and active at home, and influenced by beliefs and values related to good physical function, mental health and spiritual activities. These findings could help healthcare professionals better understand older people’ health, well-being and cultural care in order to develop alternative strategies to maintain, enhance and support an active life for homebound older people

Feasibility Study Of M-Health Transition Care Program For Traumatic Brain Injury Caregivers

Background: Caring in discharge transition for patients with moderate to severe traumatic brain injury (TBI) has impacted caregivers. MHealth has become popular for communication between a patient/caregiver and a health profession integrated into numerous public well-being programs in low-middle income countries but is limited for TBI caregivers. Purpose: This study aims to assess the feasibility of the mHealth supportive care transition program based on transitional care theory for improving discharge readiness and reducing caregivers\u27 transition stress and burden of caregiving and the patient\u27s readmission rate. Methods: Seven family caregivers who met inclusion criteria were recruited. The mHealth supportive care transition program includes education and face-to-face information assisted by an android-based application, skill demonstration, assessment of the readiness of hospital discharge, and weekly monitoring and follow-up after the patient\u27s discharge is given. The outcomes were evaluated using a validated and standardized scale designed to measure transition stress and the burden of caregiving at the baseline, two weeks, and one-month post-discharge, including the patient\u27s readmission one month (within 28 days) after discharge. Feedback through the mHealth satisfaction questionnaire on the trial feasibility was also collected. Results: The initial findings showed that all subjects experienced a decrease of stress transition and caregiver burden at two weeks and one-month post-discharge follow-up. High satisfaction scores on mHealth were also reported and no patient was readmitted within 28 days. Conclusion: This feasibility study showed the mHealth supportive care transition program is feasible for implementation, but it is required to test the effectiveness in the next phase on RCT with a larger sample size

Holistic health practices of rural Thai homebound older adults : a focused ethnographic study

Introduction:Supporting independent functioning of homebound, chronically ill older adults (HOAs) is a major concern across cultures. In Thailand, actions HOAs take to remain independent and maintain their holistic (mental, physical, and spiritual) health is understudied. Therefore, we explored self-care practices used by rural Thai HOAs to maintain their independence. Methods:We used a focused ethnographic approach, recruiting HOAs, their families, and community members from a rural area in Southern Thailand. Data were analyzed using content analysis. Results:Sixteen HOAs and 23 family/community members participated. Three themes emerged: self-care to stay healthy, sharing life with family and society in a positive way, incorporating both folk and modern medicine to maintain health. Factors facilitating holistic health practices were supportive family network, Thai cultural beliefs, community strength and support, and health care services. Discussion/Conclusions:These findings may help health care professionals develop interventions supporting holistic health practices of Thai HOAs to remain independent

Knowledge and Skills of Emergency Care During Disaster for Community Health Volunteers: a Literature Review

Background: Nowadays, disaster preparedness and responses are essential for everyone to be involved since the disaster becomes increasing. The Community Health Volunteers (CHVs) in particular are the key partners required adequately prepared in emergency care during disaster event. Purpose: The study aims to examine the essential knowledge and skills of emergency care during natural disaster for CHVs. Method: The reviews published during 2000 and 2011 searching from PubMed, Science Direct, CINAHL, ProQuest Medical Library were conducted. Result: Twenty-four articles and documents related to community-based disaster preparedness programs were intensively reviewed. Based on the review, six components of knowledge and skills for emergency care in natural disaster for CHVs are required including 1) early warning, 2) disaster triage, 3) first aid, 4) search and rescue, 5) logistic and communication, and 6) team organizations. Conclusion: There was a few studies focusing on the emergency care in disaster management and some factors related to knowledge and skills were shown. It is therefore recommended that the current CHVs' knowledge and skills should be explored in order to assist people in their community following disaster event when professional responders are not immediately available to help