Multidimensional Symptom Burden among Patients with Hemodialysis in Indonesia

Patients with hemodialysis commonly experience multiple symptoms. Most of the previous studies analyzedthe symptoms as one dimension such as the severity dimension. Conducting the comprehensive symptomassessment among patients with hemodialysis is necessary to gain a better understanding of the symptom burden.The aim of this study was to identify symptom burden among patients with hemodialysis comprehensively.This study was a descriptive study. A convenience sample of 320 patients undergoing hemodialysis was recruitedfrom the dialysis units at two referral hospitals in Indonesia (Fatmawati Hospital and Cipto MangunkusumoNational Hospital). Indonesian Version of Chronic Kidney Disease – Symptom Burden Index (CKD-SBI) wasused. For the data analysis, descriptive analysis was used. Total 320 subjects were collected. This study foundthat lack of energy was the highest physical symptom burden under 4 dimensions: occurrence 269 (84.0%),severity (mean = 4.28, SD = 3.08), distress (mean = 4.42, SD = 3.09), and frequency (mean = 4.41, SD = 3.27).Furthermore, decreased interest in sex was the highest psychological symptom burden under for dimensions:occurrence 210 (65.6%), severity (mean = 3.39, SD = 3.38), distress (mean = 2.92, SD = 2.99), frequency(mean = 3.70, SD = 3.65). Lack of energy and decreased interest in sex were consistently the highest symptomburden among patients with hemodialysis. Creating appropriate interventions and managing the symptomsexperienced by patients with hemodialysis comprehensively is very important to improve their quality of life.

Awareness of the Food-Based Diet Guidelines, Eating Practices, and Preferred Sources of Nutrition Information of Employees in an Open University in the Philippines

Physical inactivity and unhealthy diet are considered as major risk factors in the development of the “fatal four” Non-communicable Diseases (NCDs) (WHO, 2018). As the University of the Philippines Open University (UPOU) adopts a sedentary work lifestyle with most of the employees spending long hours at the office sitting in front of a computer screen, the university must be able to promote health and wellness in the workplace, particularly healthy eating. Thus, the study aimed to determine UPOU employees’ awareness of the Food-based Dietary Guidelines (FBDGs), adherence to the 2012 Nutritional Guidelines for Filipinos (NGF), and preferred sources of information on healthy eating to provide insights for the development of nutrition interventions in the university. A total of 85 healthy employees aged 19-59 years old accomplished an online adapted survey from February to April 2019 which included questions on awareness of the four FBDGs--2012 NGF; Kumainments (simplified version of NGF); Daily Nutritional Guide Pyramid (DNGP); and Pinggang Pinoy (a plate-like pictorial model), eating practices relative to the 2012 NGF, and preferred sources of information on the FBDGs. Data were analyzed using descriptive statistics. Results of the study showed that most of the respondents were not aware of the FBDGs. Among those who were aware, only a few have read the FBDGs. Adherence to the guidelines was also low as reflected by a very low percentage of respondents practicing the messages on the recommended frequency of intake of food groups. Results suggest conducting lectures or seminars and producing video materials about nutrition which can be uploaded in UPOU’s online repository of multimedia resources and social media sites to promote healthy eating practices among UPOU employees and ensure a healthy and sustainable workforce.

Severity Level and Quality of Life of Post-Acute Coronary Syndrome Patients

Severity level is one of the variables used to determine the treatments of acute coronary syndrome patients. There are many ways to see the success of treatment such as measuring the patient’s quality of life. This study aims to determine the correlation between severity level and quality of life among patients with post-acute coronary syndrome at Hasan Sadikin Central Hospital Bandung. This research was a quantitative study with a descriptive-analytic approach. Sampling of 100 patients with post-acute coronary syndrome patients was collected during a period of one month using consecutive sampling technique. The severity was assessed based on the stenosis number and the quality of life data were collected using the MacNew QLMI. Somers’d Gamma was used to analyze the data. Data showed that most of the patients had angina without stenosis (36%) and coronary 1 stenosis (29%). The results of the quality of life measurement show that 58% patients have a good quality of life, 64% are good in the emotional domain, 52% are good in the physical domain, and 60% are good in the social domain. Bivariate analysis (CI 95%) showed that there was a significant correlation between severity level and quality of life (p-value 0.033), as well as with the physical domain (p-value 0,008). There is a correlation between severity level and quality of life of post-acute coronary syndrome patients in Hasan Sadikin Central Hospital Bandung. Based on the quality of life domain, the severity level was significantly related to the physical-domain. Regular screening is necessary to improve the quality of life of post-acute coronary syndrome patients.

Depression, Anxiety and Stress among Students amidst COVID-19 Pandemic: A Cross-Sectional Study in Philippines

Background: COVID-19 considered as a global health crisis poses mental health problems among individual and specifics to students.Purpose: This study aimed to determine the depression, anxiety, and stress levels among students amidst COVID-19 pandemic in Philippines.Methods: A cross-sectional study was undertaken in Region 8, Eastern Visayas Philippines. A total of 311 tertiary respondents randomly selected both private and government owned higher education institutions. The data compilation was done using online questionnaires through Google Forms with validated version of the Stress, Anxiety and Depression Scales 21 (DASS21) is used to calculate students' level of stress, anxiety and, depression with their socio-demographic featuresResults: We revealed that depression, anxiety and stress are instituted in 18.6 %, 35.1 % and 2.85% of students, respectively, amidst the COVID – 19 pandemics. The symptoms of disorders were moderate to extremely severe in 6.1%, 23.5%, and 0.6% of the study sample, respectively. Age, gender, marital status and family history of illness are significantly different with age group 20 and below, females, singles, and families with no history of illness displaying high level of anxiety. Results also established an association between anxiety and family’s monthly income and history of illness. The higher the monthly income and no presence of illness of families, the more anxious the person.Conclusion: Finally, the variables used, explained only 1.5% depression, 3.4% anxiety and 1.4% stress in this time of COVID-19 outbreak. It is therefore recommended to essentially develop community-based mental health program for preventive purposes.

Antecedents of Psychological Empowerment and The Impact on Nurses Burnout

The purpose of this study was to examine the effect of the antecedents of psychological empowerment on burnout in nurses who worked at the COVID-19 Hospital XYZ in Tangerang during the pandemic. This research is a quantitative research with survey. PLS-SEM was used to analyse empirical data obtained through simple random sampling. There were 80 samples collected and analysed through questionnaire that had been distributed online. The results showed that six of the eight variables of quality of work life, as well as psychological empowerment mediating variables, had a significant negative effect on burnout (t-statistic > 1.645). The direct influence on psychological empowerment was found to be the strongest from the opportunity to develop human capital and adequate and fair compensation (coefficient: 0.627 and 0.361). It was found that there was a negative impact of psychological empowerment on burnout (-0.756), thus the results of this study support the theory that the quality of work life can increase psychological empowerment among nurses, as well as show a new application to the psychological empowerment of nurses. This research model has moderate predictive accuracy and medium predictive relevance, so it can be developed in further research. There are managerial implications obtained from the findings of this study related to duration of work per week, work environment, granting of autonomy, as well as recommendations for future researchers regarding sample size and geographic coverage.

The Effect of Patient Acuity Tool on Patient Clinical Practicum Assignments on Nursing Student Satisfaction Levels: A Quasi-Experimental Study

Unequal patient assignment is a problem of nursing students during clinical practicum. Registered nurses use patient acuity to ensure balanced work distribution, but its benefits has not been assessed on student nurses to date. The study’s objective is to determine the effect of patient acuity tool on student nurses’ satisfaction level during practicum. The study utilized quasi-experimental design to level II and III nursing students at a University in Quezon City, Philippines. 6-Module Online course including videos, notes, and quiz using Google Classroom was used; orientation and simulation were conducted through Zoom and Facebook Messenger. The participants were tasked randomly to use Patient Acuity Tool or conventional method during patient distribution. A modified Kuopio University Hospital Job Satisfaction Scale was used to identify and compare satisfaction levels of the two groups. Descriptive and Independent Samples T-test using Statistical Package for the Social Sciences version 26 were used to analyze data. Requiring factors, motivating factors, and working welfare of students utilizing Patient Acuity Tool are higher in overall mean satisfaction rate (3.36, 3.71, 3.89 vs 3.57, 3.81, 3.91); however, mean satisfaction showed no significant difference based on indicators (p-value 0.372, 0.694, 0.052, 0.921, and 0.469) and overall satisfaction (p-value 0.947). The requiring factors of work reflects the lowest mean scores given by those who have used the Conventional Method focusing on number of staff (2.97) and even workload distribution (2.14). Contrary to the last result, those who have distributed patients using the Patient Acuity Tools gave a mean score of 3.55.

Demographic Profile, Knowledge, Attitude, and Practices of Blood Donors in a Low-Middle Income Country

Demographic profile, knowledge, attitude and practices (KAP) of blood donors in a low-middle income setting was investigated in this study. The study determined the demographic profile of blood donors in terms of sex, age, ethnicity and level of education and measured the level of knowledge, attitude and practices in terms of blood donation. The relationship of the donor profiles in terms of level of knowledge, attitude and practices was also determined. It utilized a cross-sectional study design which was conducted from February-October 2020. A self-administered questionnaire was distributed to the volunteers of blood donors of a non-institution-based blood bank establishment in Baguio City. Descriptive statistics and Chi-square were used to analyze the data. Ethical clearance was obtained and was approved. The results revealed that the majority of the respondents were female (59.2%) with age ranged from 18–30 years old (75.3%) and in collegiate level (83.2%). Majority of the respondents’ ethnicities were Tagalog (25.9%). Study revealed that respondents have a high level of knowledge in relation to blood donation, the attitude of the respondents revealed that blood donor had strong agreement to positive statements and disagreement to negative statements. Most of the respondents donated in the past, 62.3% are lapsed donors, 18% were first time donors and the majority had an intention to donate in the future. In terms of relationship of Demographic Profile to KAP, only Practices revealed a significant relationship to sex, age, ethnicity and level of education with P value ranging from 0.05–<0.0001.

Analysis The Student Perception of Application Clinical Skills Online Learning in The Pandemic Time Covid-19

Government policies that apply social distancing, work from home, and learn from home to prevent the spread of the Covid-19 corona virus have an impact on learning methods. Clinical learning methods in pre-pandemic health education are carried out in campus laboratories and direct clinical services to patients. Thus, in this condition, the provision cannot be implemented. For this reason, it is necessary to modify the learning method from offline to online to meet the continuity of the student learning process. In the first stage, the clinical skills online learning method using online videos is supported by lecturers’ explanations in a 120-minute meeting. In the second stage, students are given the task of making videos of procedural skills that have been taught in 170 minutes, with a video duration of 10-15 minutes. At the next meeting, a review or response is carried out with students on the standard operating procedure and the theory that underlies it. The design in this study is a descriptive analysis with 511 respondents from the medical education study program and the nursing diploma 3 study program at the Faculty of Medicine, Mulawarman University. The research used was 44 items of statement questionnaire that had been tested for validity and reliability, and questionnaire items were sent to respondents via Google Forms. From the results of this study, there is a significant relationship between the perceptions of students who apply clinical skills online learning seen from the effectiveness of learning in the Covid-19 pandemic era with p-value = 0.000, with a very strong relationship with the Spearman value rho of 0.791 in a positive direction. Thus, it can be concluded that the application of online clinical skills learning during the Covid-19 pandemic was effective. As a suggestion, clinical learning methods with various blended learning or hybrid learning methods should be modified.

The Effect of Lateral Position with Head Up 45° on Oxygenation in Pleural Effusion Patients

The accumulation of fluid in the pleural cavity will interfere with the restriction process, namely disruption of lung expansion so that the air entering the lungs is less than normal. One of the effects is shortness of breath and a decrease in oxygen saturation. In this case, nursing actions play an important role in inadequate ventilation, namely positioning. The lateral position is one of the recommended positions for patients with unilateral lung disease, one of which is unilateral pleural effusion. Position selection is very important to facilitate adequate breathing, namely one with a head-up of 45°. According to some literature, the 45° head-up position can reduce consumption and maximize lung expansion which will result in greater ventilation. To determine the effect of the lateral position with a head-up 45°on oxygen saturation and respiratory rate in a patient with unilateral pleural effusion at the Dr. H. A. Rotinsulu Lung Hospital Bandung. The research design was a quasi-experimental design with one group pre and post-test design with a sample of 44 people. The sampling technique used consecutive sampling. The results showed that there were differences in median oxygen saturation and respiratory rate before and after the intervention. The results of a comparative study using the Wilcoxon test obtained a p value of 0.0001 (p value<0.05). There is an effect of giving a lateral position with a head-up 45° on increasing oxygen saturation and decreasing respiratory rate. Thus, it is expected for the service unit to establish a lateral position in the direction of the effusion with a head-up of 45°as the operational standard for the management of unilateral pleural effusion impaired oxygenation patients.

An Exploration of Nurses’ Experience of Family Presence During Resuscitation in Intensive Care Setting

The family presence during resuscitation (FPDR) has received wide support to be implemented in the ICU.Theimplementation of FPDR has positive impacts on family satisfaction. However, some of the nurses’ opinion stillnot agree on implementation of FPDR in ICU. This research therefore utilized phenomenological approach to gaindescriptive explanation regarding this phenomenon. The purpose of this study is to explore the nurse’s experiences in theimplementation of FPDR in the ICU. This research was conducted on the year 2020 and qualitative phenomenologicalapproach was utilized for this research. Ten (10) ICU nurses have participated in this study and in-depth interviewwas employed for data collection. Data analysis is conducted using Colaizzi. Result of this research areexplained in6 themes which describe the phenomenon of nurses’ experience onfamily presence during recusitation, as follows:(1) Decisions on family; (2) From burdened to selfconfident; (3) Families enhancing teamwork; (4) The bereavedfamily disrupts the CPR process; (5) Feels of ignoring patiets’ family and (6) Expectingthe family be accompaniedby staff nurse.From a nurse’s perspective, the implementation of FDPR has a positive impact on patients, familiesand on the ICU nurse team. However, this also has an unpleasant impact on ICU nurses, especially if the nurseis not ready for the practice. Therefore, policy support and training for nurses are needed in its implementation.