Contributing Factors for Perceived Satisfaction with Nursing Care among Inpatients in General Wards

Introduction: Patients' perceived satisfaction with  quality of care may affects health outcomes. Patients who are satisfied with their nursing care are more likely to follow treatment and consequently to have better health outcomes. It encourages them to behave in a healthy way after discharge, and positive rating of service quality seems to be correlated with no hesitation about revisiting the same hospital ward in time of need. This study was done to identify the contributing factors for perceived satisfaction with nursing care among inpatients in general wards in Lumbini Medical College. Methods: A descriptive cross sectional study was conducted in Lumbini Medical College Teaching Hospital throughout the month of August, 2015. A total of 60 heterogeneous study population from three different wards (Medical, Surgical, and Orthopedics), who gave consent for participation, were included using non-probability convenient sampling technique. Nepalese version of  Newcastle Satisfaction with Nursing Scale (NSNS) was used to measure the satisfaction score. Results: There were a total of 60 respondents with mean age of 30.08 years (SD= 9.72). Male, duration of hospital stay, and number of hospital stay had a significant relation with the satisfaction score when calculated individually. However, the relationship was not significant when adjusted for other variables by linear regression. Conclusion: Majority of respondents were satisfied with the quality of nursing care. Male, duration of hospital stay, and number of hospital stay had a significant relation with the satisfaction score when calculated individually. The nurses should know the factors influencing patients' satisfaction and work on those to improve the quality of nursing care

Risk Factors for Obesity in Nepalese Women: A Cross-sectional Study

Introduction: Obesity is defined as abnormal or excessive fat accumulation that may impair health. It ison the rise worldwide, not sparing developing countries. Both demographic and socioeconomic factors playan important part in its causation. Body mass index is a simple index of weight-for-height that is commonlyused to classify overweight and obesity in adults. This study was done with objectives of assessing the prevalence of overweight and obesity and its associated factors among adult women attending selected outpatient departments of tertiary care center in western region of Nepal. Methods: A descriptive cross-sectionalthe study was conducted for six months. A total of 160 female respondents aged more than 20 years attending outpatient departments were included in the study using non-probability convenient sampling technique. Data on socio-demographic status, dietary pattern, health risk behavior and presence of chronic illness were collected and anthropometric measurements were taken for all the respondents. Results: The prevalence of overweight and obesity were 31.8% and 3.8% respectively. There was a statistically significant association between obesity and overweight with age (p=0.044), educational status (p=0.017), frequency of consumption of fruits (p=0.029), dietary pattern (p=0.023), frequency of consumption of dairy products (p=0.019), marital status (p=0.020) and drinking alcohol (p=0.022). Conclusion: Age, educational status, frequency of consumption of dairy products, dietary habits, marital status and drinking habits were strongly associated with obesity and overweight among adult women

Fatigue and Sleep Quality Among Staff Nurses Working in A Tertiary Care Hospital During COVID-19 Pandemic

Introduction: Fatigue, a universal phenomenon, is a suboptimal psychophysiological condition caused by physical and/or mental exertion. Insufficient recovery between work shifts causes accumulated acute fatigue to progress into chronic. As fatigue and sleep quality are related, adequate sleep and inter shift recovery are thus vital to the overall health. The current COVID-19 pandemic has caused added burden to the nursing workforce worldwide. This study aimed to assess fatigue and sleep quality among staff nurses of a tertiary care hospital during the pandemic. Methods: A descriptive cross-sectional study was conducted among 151 staff nurses of Lumbini Medical College and Teaching Hospital (LMCTH) using enumerative sampling method. Valid and reliable instruments i.e., Occupational Fatigue Exhaustion Recovery (OFER) and Pittsburgh Sleep Quality Index (PSQI) were used. Analysis was done using descriptive and inferential statistics. Results: The mean ±SD age of the participants was 26.54±6.93 years. Less than half (39.1%) of them had moderate to high acute fatigue. Nearly half (41.2%) had high chronic fatigue and most (61.6%) had low to moderate inter shift recovery. Poor sleep was found among 60.9% of the participants with mean global PSQI score of 6.74. Sleep quality had moderate positive correlation with chronic (r=0.4, p<0.001) and acute (r=0.39, p<0.001) fatigue whereas had moderate negative correlation with inter shift recovery (r=- 0.41, p<0.001) which were statistically significant. Conclusion: The staff nurses had fatigue and poor sleep during COVID-19 pandemic. Nursing administration should take appropriate measures timely to decrease fatigue and improve sleep to prevent serious consequences

An Experience of Optimizing A Community-Based Micro-Insurance Model to Bridge the Gap between Treatment Cost and Ability to pay at BPKIHS

In the year 2001 the leaders of BPKIHS started a micro social insurance scheme; Social Health Insurance (SHI) for prospective research. It is a method of financing and managing health care using compulsory contributions from employers, employees and may be from the government. Household members from organized groups in catchment areas enrolled voluntarily. Photographed service cards were issued entitled for free IPD/OPD consultations, investigations and bed charges excluding CT scans and specialty treatment. Institute bore operation and medicine costs up to 10000 and 3500 respectively for IPD yearly. Premium was fixed after a research through focus group discussion in villages of Morang, Sunsari and Biratnagar. A flat rate premium of 15 and 50 NRS/adult/month for villagers, city dwellers and half for children was fixed. Marginalized community and handicapped paid 33% of premium, 33% by Institute and 33% by concerned VDC. As the client number increased from 2383 to 7392 in second and to 15779 in third year, Premium: Expenditure ratio moved from 225:222 to 198:391. Average cost sharing of premium to expenditure came to 226:332 showing a negative balance. This scheme completed its fourth year till this research in 2005 A.D. But it was closed due to deficit. As reinsured population occasionally concealed information by not incorporating all family members. They defaulted in subsequent year after utilizing the benefits of SHI and misused the card for uninsured ones. It may, in its optimized form, become a model to be widely adopted to bridge the gap between the cost of treatment and the ability to pay in developing countries