Impact of an educational intervention on cancer palliative care among nurses

Objectives: To evaluate the impact of an educational intervention on the knowledge of nurses providing palliative care (PC)Methods: Nurses were selected from the medical and surgical oncology units of National Institute of Cancer Maharagama (NICM) (n=38) and Teaching Hospital Karapitiya (THK) (n=37) using convenient sampling technique as the intervention and control groups respectively. An educational intervention was prepared including printed material and DVD on cancer PC. The duration of the intervention was eight weeks. Pre and post intervention assessment of knowledge was done on intervention and control group. Ethical approval was obtained from the ethical review committee of the Faculty of Medical Sciences. Independent t-test and ANOVA were applied to determine significant differences (p>0.05).Results: The age, educational qualifications and the professional experience was similar in the two groups. Pre intervention knowledge was similar in the intervention (28.61±6.66) and the control (28.73± 5.31) groups. However, the knowledge of intervention group improved significantly immediately after the intervention (47.00±3.93). Further when assessing knowledge of nurses 12 weeks after the intervention, there was a significant improvement in knowledge of intervention group (50.36±3.97) when compared to control group (28.23±4.88). When comparing the pre-intervention knowledge of intervention group (28.61±6.66) the post intervention (12th week) knowledge was significantly higher (50.36±3.97).Conclusions: The educational intervention for nurses on cancer palliative care was effective in improving knowledge

Physical and psychological morbidities among selected antenatal females in Kegalle district of Sri Lanka: A cross sectional study

While motherhood is often a positive and satisfying experience, for some women, it is linked with suffering and ill-health. A woman should be able to feel physically and mentally content during pregnancy. Discomforts in pregnancy may be considered as insignificant by the physician. Therefore, the objective of this study was to determine physical and psychological morbidities among primigravid antenatal females in the Kegalle District, Sri Lanka. A sample of 1017 second and third trimester primigravid antenatal females selected by a two-stage probability proportional to size cluster sampling method, were assessed for physical and psychological problems. Data analysis was done using SPSS 16 package and associations were found using Chi square test with p values. The presence of any physical health problem during the preceding 14 days was reported by 75.7% (95% CI 73.0–78.2) of females though each individual physical problem was reported by less than or around one-third. Prevalence of psychological distress and depression was 22.7% (95% CI 20.2–25.4) and 10.4% (95% CI 8.7–12.4), respectively. The self-rated health was very good in 24.7% and good in 55.9%. Older employed females had significantly higher physical problems. It is concluded that although the self-rated wellbeing during pregnancy is high, the presence of physical and psychological ill-health is substantial.Impact statement Pregnancy is a time of intense physical change and is associated with emotional upheaval in many women. Obstetric morbidity is defined as morbidity in a woman who has been pregnant regardless of the site or the duration of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It is classified into three categories namely; direct, indirect and psychological obstetric morbidity. For one maternal death, there can be between 9 and 16 females with obstetric morbidity depending on the level of development of a country. As a country with good health indicators, this study was conducted to determine physical and psychological problems among primigravid antenatal females in the Kegalle District,p Sri Lanka to improve service quality further. The presence of any physical health problem during the preceding 14 days was reported by a quarter of females and backache, fatigue, body aches, psychological distress, urinary incontinence and headache was commonly reported individual problems. Older employed females had significantly higher physical problems. Though trivial for health workers, physical and psychological problems are prevalent. These should be actively sought and remedied by health workers to improve the quality of life

A Review of Sociological Theories of Suicide and Their Relevance in Sri Lankan Context

Suicide is one of the leading causes of morality in Sri Lanka (Mnistry of Health Sri Lanka, 2001). It causes a major burden to the individual, family, the health care delivery system and the society at large. In addressing this important issue in an aetiological perspective, examining sociological theories is of special value, considering the high rate of suicide, which cannot be solely explained by mental ill health of the population. The earliest sociological explanations for suicide were presented by Emile Durkheim, a French sociological theories of suicide, namely anomic, egoistic, altruistic and fatalistic. The social elements described were subsequently expanded by several other sociologists. These include theories of social isolation, role conflict, imitation, reaction from the society, opportunity, social integration and rational suicide. The understanding of the sociological theories would help researchers and service providers to focus on an important, yet neglected aspect of the role of the society in relation to the high rate of suicide in the country. In addition, it is of value in formulating preventive strategies in a broader perspective.This paper discusses the sociological theories with case examples from Sri Lanka

Erectile dysfunction is a strong predictor of poor quality of life in men with Type 2 diabetes mellitus.

AIMS: To identify predictors of poor quality of life among men with diabetes from a comprehensive set of sexual, clinical, socio-economic and lifestyle variables. METHODS: This was a cross-sectional observational-study of 253 men with Type 2 diabetes, randomly selected from a clinic in Colombo, Sri Lanka. Erectile dysfunction was assessed using the five-item International Index of Erectile Function and quality of life was assessed using the Sri Lankan version of the 36-item short form health survey questionnaire and the disease-specific Psychological Impact of Erectile Dysfunction scale. The presence of premature ejaculation, reduced libido, socio-demographic and lifestyle data was obtained using an interviewer-administered questionnaire. Significant predictors of quality of life were identified by stepwise multivariate linear regression models for short form-36 subscales, summary scales and two scales of Psychological Impact of Erectile Dysfunction. RESULTS: Significant predictors on the physical summary scale of the 36-item short form were erectile dysfunction (β = 7.93, 95% CI 3.70-12.17, P < 0.001) and reduced libido (β = 5.20, 95% CI 0.82-9.59, P < 0.05). Predictors on the mental health summary scale of the 36-item short form were erectile dysfunction (β = 5.82, 95% CI 2.26-9.37, P < 0.01), BMI > 27.5 kg/m(2) (β = 9.12, 95% CI 1.38-17.44, P < 0.05), ischaemic heart disease (β = 6.39, 95% CI 0.74-12.04, P < 0.05) and insulin therapy (β = 5.28, 95% CI 0.34-10.22, P < 0.05). Significant predictors in the sexual experience scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 6.57, 95% CI 4.63-8.51, P < 0.001), reduced libido (β =4.33, 95% CI 2.34-6.32, P < 0.001) and postural hypotension (β = 3.99, 95% CI 0.13-7.85, P < 0.05). Predictors on the emotional life scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 2.96, 95% CI 1.37-4.58, P < 0.001), reduced libido 2.75 (β = 2.75, 95% CI 1.12-4.40, P < 0.01), younger age (β = 1.05, 95% CI 0.35-1.75, P < 0.01) and postural hypotension (β = 3.39, 95% CI 0.35-6.45, P < 0.05). CONCLUSION: Erectile dysfunction was a strong predictor of poor generic and disease-specific quality of life among other sexual and clinical variables in men with diabetes