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Validation of short version of evidence-based practice instruments among nurses in clinical practice: Evidence-based practice beliefs, implementation, and organizational culture
Easter Chukwudi OSUCHUKWU, Chinwe Florence EZERUIGBO
Journal of Integrative Nursing    2023, 5 (3): 173-178.   doi: 10.4103/jin.jin_67_23
Abstract35)      PDF(pc) (564KB)(3)      


The objective of the study is to validate the short version of evidence-based practice (EBP) instruments among nurses in clinical practice.


An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians. The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales: the shortened versions of the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice (OCRSIEP) survey. With the use of descriptive statistics, the data were analyzed and presented in frequencies and percentages, while inter-item correlation coefficient (ICC) and the Kaiser-Meyer–Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis.


Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61, EBP Implementation Scale ranged from 1.84 to 1.94, and the OCRSIEP Scale ranged from 1.93 to 2.19. All the three shortened scales accordingly had good internal reliability, 29.30 ± 9.93 out of 80 for the EBP Beliefs Scale, 19.56 ± 7.37 out of 72 for the EBP Implementation Scale, and 66.32 ± 20.35 out of 125 for the OCRSIEP Scale.


This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

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Effectiveness of lukewarm water compress on reduction of breast pain and breast engorgement among post-cesarean section mothers
Soni CHAUHAN, Kumari NUTAN, Monica AGRAWAL, Surya Kant TIWARI
Journal of Integrative Nursing    2023, 5 (3): 167-172.   doi: 10.4103/jin.jin_25_23
Abstract33)      PDF(pc) (570KB)(2)      


The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.

Materials and Methods: 

This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019. A simple random sampling technique was used to allocate 30 participants to both experimental and control groups. The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second, third, and fourth postnatal days. The control group received routine hospital care. Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third, fourth, and fifth postnatal days.


Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers (P < 0.001). In addition, no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement (P > 0.05).


Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers. Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement.

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Heart failure symptom burden, dietary intake, and inflammation: An integrative review of the literature
Erica DAVIS, Sandra DUNBAR, Melinda HIGGINS, Kathryn WOOD, Erin FERRANTI, Alanna MORRIS, Brittany BUTTS
Journal of Integrative Nursing    2023, 5 (2): 81-92.   doi: 10.4103/jin.jin_26_23
Abstract32)      PDF(pc) (694KB)(19)      

Heart failure (HF) is characterized by high symptom burden including, but not limited to fatigue, dyspnea, and edema. Up to 21.5% of HF patients experience significant depressive symptoms, much higher than 7.1% in adults without HF. Diet, metabolites, and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF. Symptoms for black adults (B/As) with HF are often influenced by lifestyle factors, which may influence their higher mortality rates; few studies address these factors. Distinguishing the links between key elements with diet, inflammation, and symptoms may bring clarity for new dietary strategies in HF clinical care. The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation, dietary intake, tumor necrosis factor-alpha (TNF-a), a biomarker of inflammation, and trimethylamine-N-Oxide (TMAO). Based on available evidence, inflammation may be a key link between physical symptoms, diet, depression, TMAO, and TNF-a in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications. The literature reviewed in this study demonstrates that more work is needed to examine dietary planning, social support, and differences between men and women in the B/A community. Results of this literature review call attention to the essential, personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population.

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Operating procedures of moxibustion technology
Yali WANG, Ling TANG, E. HAIYAN, Yongchun WEI, Jing JIANG, Yuxia DONG
Journal of Integrative Nursing    2023, 5 (3): 228-233.   doi: 10.4103/jin.jin_57_23
Abstract30)      PDF(pc) (512KB)(11)      
Moxibustion therapy is a treatment and health-care method that originated from China. It is a kind of therapy for preventing and treating diseases by stimulating meridians and acupoints using heat to regulate the viscera and enhance immunity. This article introduces the definition and mechanism of moxibustion technology, clinical operation technics, and precautions of moxibustion in practice, and demonstrates plenty of iconic cases of application of moxibustion in the treatment of insomnia, dysmenorrhea, urinary retention, knee arthritis, chronic eczema, etc., so as to provide a reference for the wide application of moxibustion technology.
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Prevalence of social media addiction among nursing students
Marwa Mamdouh SHABAN, Nagah Mahmoud ABDOU, Mahmoud Magdy EID, Mostafa Ahmed IBRAHIM, Mohammed Saad El Dean METWALY, Mohamed Abdeltwab SAYED, Youmna Magdy Abdulwahab MANSOUR, Fatma Saad RAMADAN
Journal of Integrative Nursing    2023, 5 (2): 145-150.   doi: 10.4103/jin.jin_127_22
Abstract29)      PDF(pc) (588KB)(20)      

Objective: The objective of this study was to assess the prevalence and level of social media addiction among nursing students in the Faculty of Nursing, Cairo University.
Materials and Methods: A descriptive cross-sectional research design was conducted on samples of 340 students at the Faculty of Nursing, Cairo University. Data were collected through demographic background information sheet and Social Networking Addiction Scale.
Results: All the students were addicted as 6.76% were severely addicted and 60.59% and 32.65% were moderately and mildly addicted, respectively. Significant relations were found between social media addiction and students' age (χ2 = 11.331, P = 0.003), educational level (χ2 = 20.239, P = 0.003), and grade point average (χ2 = 19.378, P = 0.013).
Conclusion: Internet addiction was prevalent among all students but at different levels, so early screening of students for Internet addiction using the Internet Addiction Scale is important to provide early treatment and prevent hazards to health.


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Training needs in intravenous infusion care for children in China: A cross-sectional study
Jingjing LI, Jiaxin FANG, Liu HAN, Junhan YANG, Xueyan FAN, Dahua ZHANG
Journal of Integrative Nursing    2023, 5 (2): 122-131.   doi: 10.4103/jin.jin_97_22
Abstract29)      PDF(pc) (661KB)(21)      

Aim: This study aims to evaluate demands for general and pharmacological knowledge and training related to intravenous (IV) therapy among pediatric nurses.
Materials and Methods: This multicentric cross-sectional study involved 12,707 pediatric nurses from 100 hospitals in China. A questionnaire was used to assess information about IV drug administration training received, and the demands for pharmacology-related knowledge, and corresponding methods of acquisition. A generalized linear model using Logit link function was employed to assess relationships between factors and multivariate analysis was conducted.
Results: More than 99% of participants showed their training demands for IV therapy training. Pediatric nurses' demands and methods for acquiring IV therapy knowledge and the knowledge related to IV therapy pharmacology have significant differences in social demographic factors, previous knowledge, whether they have received training or not, and other factors (all P < 0.05). Received a needlestick injury in the past month (P = 0.007) and knowledge acquired through in-hospital or out-of-hospital training (P = 0.039) were factors that reduced the demands for methods to acquire further pharmacology-related knowledge of IV therapy. Working in internal medicine (P = 0.025) and not having experienced a needlestick injury in the past year (P = 0.007) reduced the demands for IV therapy knowledge. Attended hospital (P = 0.007) or departmental meetings (P = 0.009), being pediatric primary nurses (P = 0.044), and studied special IV guidelines (P = 0.006) reduced the desire for methods to acquire IV therapy knowledge.
Conclusion: There was a high demand for greater general and pharmacological knowledge related to IV therapy among pediatric nurses. Resources should be coordinated to provide ongoing training to nurses to improve the quality of IV care.

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Accessible and low‑ to zero‑cost remedy: Traditional medicine use during pregnancy and labor
Modupe Motunrayo ADAMOLEKUN, Oluwaseyi Abiodun AKPOR, Oghenerobor Benjamin AKPOR, Oluwakemi Elizabeth ADEOLA, Olusola Bolaji ADEWALE
Journal of Integrative Nursing    2023, 5 (2): 75-80.   doi: 10.4103/jin.jin_85_22
Abstract27)      PDF(pc) (483KB)(22)      

Traditional medicine (TM) has played an essential part in maternity services around the world, which has led to increased utilization among pregnant women. Herbs, herbal preparations, and completed herbal products are examples of TMs that contain active substances such as plant parts or other plant components that are thought to have therapeutic advantages. This study review aimed to identify the herbs commonly used, reasons for use, and effect of use, to make adequate recommendations on herbal medicine use as a remedy for pregnancy and labor. Incorporating evidence from reviews, personal correspondence, and diaries, this study demonstrates that about 80% of people used TM such as herbal remedies for sickness diagnosis, prevention, treatment, and promotion of general well-being. Due to its accessibility, cost, and availability, TM is usually used by expectant mothers. Examples of TM used in pregnancy and labor include honey, aloe, raspberry, jute mallow, and hibiscus leaves. It is important to note that its use in pregnancy and labor can be beneficial or harmful to both mother and child. Lack of standardization, financial risk, lack of safety, and effectiveness are challenges to TM. There is a need of creating awareness of the safe use and effects of TM in pregnancy and labor through the provision of health education programs for women in the community.

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Technical operation specification for cupping therapy
Yongchun WEI, Yali WANG, Haiyan E, Kaiye ZHANG, Ling TANG
Journal of Integrative Nursing    2023, 5 (2): 155-160.   doi: 10.4103/jin.jin_24_23
Abstract26)      PDF(pc) (545KB)(16)      

Cupping, as one of the characteristic therapies of traditional Chinese medicine, has been applied for more than 2000 years and has a unique curative effect in clinic. With the evolution of the times, the types and operation techniques of cupping method are also iterating. In the process of its inheritance and development, cupping technology is also known by more and more people. Starting from the development and efficacy of cupping method, this paper introduces the clinical operation steps and precautions of cupping method in detail, and lists the representative diseases such as lumbar muscle strain, herpes zoster, and ankylosing spondylitis, to provide reference for clinical application.


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Early warning systems for enteral feeding intolerance in patients with stroke
Guiying LIU, Yanyan ZHANG, Ling TANG
Journal of Integrative Nursing    2023, 5 (2): 132-137.   doi: 10.4103/jin.jin_121_22
Abstract25)      PDF(pc) (649KB)(23)      

Objective: The objective of this study was to construct an early warning system (EWS) to facilitate risk assessment, early identification, and appropriate treatment of enteral nutrition feeding intolerance (FI) in patients with stroke, so as to provide a reference for risk classification standards and interventions toward a complete EWSs for nursing care of stroke.
Materials and Methods: Based on evidence and clinical nursing practice, a structured expert consultation method was adopted on nine experts over two rounds of consultation. Statistical analysis was used to determine the early warning index for FI in patients with stroke.
Results: The expert authority coefficient was 0.89; the coefficients of variation for the two rounds of consultation were 0.088–0.312 and 0.096–0.214, respectively. There were significant differences in the Kendall's concordance coefficient (P < 0.05). Finally, 22 items in five dimensions of patient age, disease, treatment, biochemical, and enteral nutrition-related factors were identified.
Conclusion: The early warning index for FI in patients with a history of stroke is valid and practical. It provides a reference for the early clinical identification of FI risk.

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The impact of nurses’ organizational commitment on their perceptions of the work environment: Strong mediating effect of the psychological contract
Pengxiang ZUO, Cengceng LU, Jing ZHOU, Ming HOU, Xiaohui JIAO
Journal of Integrative Nursing    2023, 5 (2): 115-121.   doi: 10.4103/jin.jin_118_22
Abstract25)      PDF(pc) (841KB)(20)      

Objective: The objective is to assess the direct and indirect effects of nurses' organizational commitment (OC) on their work environment perceptions (WEP) and the role of the psychological contract (PC).
Methods: A cross-sectional quantitative study of 3047 registered nurses in four Chinese hospitals was conducted. The Essentials of Magnetism II (Chinese version), OC, and PC scales were used in the study, and the structural equation modeling was used to assess the connections among variables.
Results: The results showed that OC was positively correlated with WEP (r = 0.561, P < 0.001), and PC was negatively correlated with the WEP (r =  0.717, P < 0.001), and OC (r =  0.739, P < 0.001). Nurses' PC played a strong mediating role between OC and WEP, accounting for 87.64% of the total effect. Besides, PC played an important role in creating a healthy work environment.
Conclusions: The exploration of the relationships among WEP, PC, and OC provides new insights for hospital managers to build a better work environment for nurses, which is conducive to maintaining a stable nurse team and providing high-quality nursing services for patients.

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Diabetes self-management education: Benefits and challenges
Ibironke Cecilia OJO, Elizabeth Olufunmilayo OJO, Simeo Kayode OLUBIYI
Journal of Integrative Nursing    2023, 5 (2): 93-101.   doi: 10.4103/jin.jin_105_22
Abstract25)      PDF(pc) (565KB)(21)      

Diabetes mellitus has spread throughout many nations of the world and is now a serious threat. A lack of patient self-management has been linked to this drain on global health. The consequences of diabetic patients' poor self-management have increased a variety of complications and lengthened hospital stays. Poor information and skill acquisition have been linked to poor self-management. Participating in a co-operative approach known as diabetes self-management education will help diabetes patients who want to successfully self-manage their condition and any associated conditions. Information is one of the most important components of a diabetes management strategy. In conclusion, numerous studies have shown that patients with diabetes have poor self-management skills and knowledge in all areas, making training in diabetes self-management necessary to minimize the complications that may result from diabetes mellitus among the patients. This review discussed the severity of diabetes mellitus, diabetes self-management, and the benefits and challenges of diabetes self-management, which may aid individuals in understanding the significance of diabetes self-management and how it relates to diabetes self-care.

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Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology
Chinomso Ugochukwu NWOZICHI, Olaolorunpo OLORUNFEMI
Journal of Integrative Nursing    2023, 5 (2): 102-107.   doi: 10.4103/jin.jin_117_22
Abstract24)      PDF(pc) (848KB)(18)      

The intensive care unit (ICU) is a complex setting by nature, and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous, constant activity, equipment, bright lights, and high fatality rate. The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health-care professionals from acknowledging the feelings of patient's relatives or family caregivers, resulting in a hostile environment from the patient's relative's perspective. When a patient's family enters the ICU, they feel that hospital administrators do little to nothing to alleviate their discomfort and fear. Despite research demonstrating the importance of providing a homely environment for patients' families, In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient's relations in the unit. The goal of this study was to look at the patient's relative's perspective on providing care for a critically ill patient in an ICU, with a focus on the unit's complexity and overall experience. Based on the findings of this study, we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient's relatives by addressing identified environmental concerns, like caring neglect, by providing a friendly and stress-free environment.

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Operating procedures of traditional Chinese medicine breast massage
Jingjin XU, Hong CHEN, Jing ZHANG, Jiaji LI, Ye LI, Ling TANG
Journal of Integrative Nursing    2023, 5 (2): 151-154.   doi: 10.4103/jin.jin_27_23
Abstract24)      PDF(pc) (516KB)(18)      

Traditional Chinese medicine breast massage, also known as breast Tuina or manual expression of breast milk, is a technique of using certain manipulations to act on specific positions or acupoints of the breast to promote blood and lymphatic circulation of breast and facilitate the discharge of stagnant milk. This technique is widely used in China to treat breastfeeding problems such as breast engorgement, mastitis, and postpartum hypogalactia. In this article, we introduce the definition and standardization process of breast massage, elaborate the operating procedures of breast massage in detail, and summarize and discuss the current situation of its clinical application, so as to provide a reference for its wide application and in-depth research.

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Work‑related quality of life and performance appraisal among nurses at a tertiary hospital in Philippines
Alvin Duke R. SY, Ma. Krisstella D. GONZALES, Rachel Camille C. RODRIGUEZ
Journal of Integrative Nursing    2023, 5 (3): 179-187.   doi: 10.4103/jin.jin_7_23
Abstract24)      PDF(pc) (563KB)(15)      


The objective of the study is to describe the work-related quality of life (WRQOL) among nurses and explore its association with performance evaluation ratings.


A cross-sectional design was utilized measuring the WRQOL scale and the previous performance appraisal rating. Multistage sampling approach was utilized with nurses stratified based on their position and then systematically random sampled based on their unit assignment.


One hundred and eighty-two nurses were included. About half reported a high quality of work life (101; 55.5%). Low scores were noted on the subscale working conditions (100; 54.9%), low to average responses for home-work interface (109; 59.9%), control at work (100; 54.9%), and stress at work (90; 49.5%). A higher proportion of nurses reported positive responses toward the areas of general well-being (113; 62.1%) and job-career satisfaction (112; 61.5%), than in the other subscales. There were notable differences between WRQOL ratings: (1) Head nurses had the highest perceived quality of work life, followed by nurse supervisors and charge nurses (F = 6.1, P < 0.01) and (2) Nurses in the pay-patient services reported lower quality of working life, while those in office and outpatient services had more positive scores (F = 4.6, P < 0.01).


Only more than half of the nurses reported a high quality of work life, some of its dimensions, particularly job and career satisfaction and working conditions, appeared to vary in the perceived degree across years in service, work hours, and position. The assessment of the quality of work life may serve as an important tool to address staff burnout, absenteeism and other issues that affect job performance among health-care professionals.

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Pediatric thermal burn injury: A retrospective analysis from pediatric care institutes, Eastern India
Kartik Chandra MANDAL, Sourav ROY, Pankaj Kumar HALDER, Partha CHAKRABORTY, L. NEILASANO, Debasree GUHA
Journal of Integrative Nursing    2023, 5 (2): 108-114.   doi: 10.4103/jin.jin_4_23
Abstract23)      PDF(pc) (589KB)(24)      

Objective: Pediatric burns pose difficult healthcare issues in underdeveloped nations. Due to the scarcity of pediatric burn care facilities and qualified burn-care staff, patients are frequently referred from a rural hospital. This study explores the burn-treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.
Materials and Methods: A retrospective analysis of clinical data of 199 children who received treatment for burn-injury in an isolated general surgical ward. Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort. Until the wounds healed, the treatment was repeated every alternate day. The patient's demographic data, number of surgical dressings, length of hospital stay, and outcome were analyzed.
Results: The mean age of the patients was 51.68 ± 23.79 months. The male-female ratio was 1.45:1. The survival rate was 99.00%. The disability rate was 4.52%. Univariate logistic regression identified the age group, total body surface area affected, depth of the wound, and time of intervention as statistically significant variables (P < 0.05) predicting the disfigurement. Multivariate logistic regression identified the time intervals between surgical intervention and injury as an important predictor of morbidity. In addition, delayed presentation and delayed intervention led to a longer hospital stay, and more interventions than the early intervention cohort.
Conclusions: Early debridement accelerates recovery and lessens the need for future skin grafts or contracture procedures. This approach can be used in rural hospitals as well because pediatric burns can be manageable in an isolated general ward.

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Impact of designed infection control educational program on nurses’ knowledge and compliance with standard precautions at maternity hospitals
Journal of Integrative Nursing    2023, 5 (2): 138-144.   doi: 10.4103/jin.jin_120_22
Abstract23)      PDF(pc) (727KB)(20)      

Objectives: This study aimed to assess the nurses' knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses' knowledge and compliance with standard precautions at the maternity hospital.
Materials and Methods: A quasi-experimental one-group pretest-posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital, Kasr El Ainy, who received “designed infection control educational program” for 6 months. The data were collected through the questionnaire comprising demographics, knowledge, and compliance with standard precautions questionnaire. The nurses' knowledge and compliance score were compared before and after intervention.
Results: The studied nurses had higher level of knowledge (85.3%) and compliance (92.8%) regarding infection control standard precautions after the educational program compared to before the program. The results revealed statistically significant difference between before and after the program regarding nurses' knowledge score (15.5 ± 2.9 vs. 17.1 ± 1.6, P < 0.001) and compliance score (58.5 ± 13.2 vs. 74.3 ± 5.1, P < 0.001). In addition, there was insignificant relation between nurses' knowledge and compliance with standard precautions both before (r = 0.952, P = 0.474) and after educational program (r = 0.164, P = 0.223).
Conclusion: The nurses' level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program. Therefore, it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.

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Predictors of death in hospitalized elderly patients with COVID‑19 in Mashhad, Iran, in 2021: A historical cohort study
Vajihe BINIAZ, Alireza Afshari SAFAVI, Forogh ZAMANI, Mozhgan RAHNAMA, Abdolghani ABDOLLAHIMOHAMMAD, Eshagh ILDARABADI
Journal of Integrative Nursing    2023, 5 (4): 243-249.   doi: 10.4103/jin.jin_110_23
Abstract23)      PDF(pc) (802KB)(7)      

Objective: The present study aimed to identify predictive factors for mortality among elderly individuals infected with COVID?19.

Methods and Materials: This historical cohort study was conducted from July to December 2021 in the specialized departments for COVID?19 patients at one of the hospitals in Mashhad, Iran. Data were collected from the medical records of 404 elderly patients. Sampling was conducted using the convenience sampling method. Data were gathered through a demographic and clinical checklist developed by the researcher. Univariate and multivariate Cox regression were used to analyze the data.

Results: The mortality rate among elderly individuals was 25% (n = 101). Multiple regression analysis revealed significant associations between mortality and age (hazard ratio [HR] = 0.58, 95% confidence interval [CI]: 0.38, 0.88; P = 0.011), level of consciousness (HR = 0.31, 95% CI: 0.19, 0.50; P < 0.001), and SpO2 (HR = 0.58, 95% CI: 0.37, 0.92; P = 0.022). The probability of survival after the 19th day of hospitalization was 50%.

Conclusions: Determining predictors of death allows for early identification of elderly individuals at risk and enables the health?care team to provide more effective care, ultimately saving the lives of elderly individuals by allocating appropriate facilities and equipment.

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Technical operation specification for pricking–cupping therapy
Jiaji LI, Jingjin XU, Jing ZHANG, Ling TANG, Hong CHEN, Ye LI
Journal of Integrative Nursing    2023, 5 (3): 223-227.   doi: 10.4103/jin.jin_79_23
Abstract21)      PDF(pc) (464KB)(3)      
Pricking–cupping therapy is a Traditional Chinese Medicine (TCM) nursing technology that can adjust the viscera of the human body, make the meridians smooth, and Yin and Yang balanced mainly by means of relieving heat and detoxification, harmonizing Qi and blood, promoting blood circulation and removing blood stasis, dredging meridians and activating collaterals, reducing swelling and pain, purging heat and calming shock, clearing heat, and opening orifices. Pricking–cupping therapy has a long history and wide application. After thousands of years of development, it has made great progress. They are widely used to treat lumbar disc herniation, herpes zoster, acute arthritis, migraine, and other diseases in China. Through the clinical practice and theoretical exploration of physicians of past dynasties, the therapeutic mechanism and application scope of pricking–cupping therapy have been greatly enriched. Modern TCM practitioners have conducted in-depth researches on the operation norms of the therapy on the basis of the ancients, hoping to grasp the essence of the disease more accurately and make the rational use of the operation technology of the therapy.
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Exploring internship nursing students’ perception of gerontological nursing competencies: A descriptive study at Cairo University Hospitals
Naglaa El‑Sayed ELDARDERY, Ebtesam Mo’awad El‑Sayed EBIED, Yousef MOHAMMED, Kholoud KHODARY, Basmala MOHAMMED, Sara MOHAMMED, Kholoud MOHAMMED, Ahmed KAMAL, Mostafa SHABAN
Journal of Integrative Nursing    2023, 5 (4): 235-242.   doi: 10.4103/jin.jin_91_23
Abstract21)      PDF(pc) (551KB)(7)      

Objective: This research study explores the perceptions of gerontological nursing competencies, attitudes toward older individuals, and the willingness to provide care for the elderly among internship nursing students.

Materials and Methods: A convenience sample of 350 internship nursing students from Cairo University Faculty of Nursing participated in the study. Data were collected using a set of comprehensive tools, including personal data and work experience assessment, the Hartford geriatric nurse competency tool, Kogan’s attitudes toward old people scale, and the modified elderly patient care inventory.

Results: Descriptive analysis revealed balanced gender representation, with 60% identifying as female. Seventy percent of participants reported prior experience in gerontological care. Self-assessed competency scores indicated moderate proficiency in communication, physiological changes, and functional status assessment. Areas such as pain management and restraint use demonstrated potential gaps in self-perceived skills. Attitudes toward older individuals were predominantly positive, and the willingness to provide care showed positive tendencies, with a minor degree of hesitation noted.

Conclusion: The findings underscore the need for targeted interventions in nursing education to address competency gaps, enhance positive attitudes, and alleviate potential hesitations in caregiving for older individuals. As the elderly population continues to grow, nursing education programs must prepare future practitioners to deliver comprehensive and compassionate care tailored to the unique needs of older adults.

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Telehealth utilization among Egyptian population and health institutional readiness: An exploratory study
Basma Mohamed OSMAN, Maaly Zayed MOAMED, Shaimaa Ali Mohamed ISMAIL, Lamiaa Saad Abd ALLAH, Marwa Mamdouh SHABAN
Journal of Integrative Nursing    2023, 5 (3): 188-196.   doi: 10.4103/jin.jin_37_23
Abstract20)      PDF(pc) (609KB)(4)      


This study aimed to assess the public’s perspectives and the health institutions’ readiness for telehealth utilization in Egypt.


A cross-sectional study design was employed, and data were collected from a convenient sample of 800 Egyptian citizens and 26 nursing administrators and information technology personnel from 16 governmental hospitals and 10 private hospitals between January and March 2022. The Egyptian community utilization of telehealth questionnaire and the telemedicine hospital readiness assessment were used to collect the data.


The results revealed that 35.1% of the general Egyptian population used telehealth services and 43% expressed willingness to use them in future. As perceived by the general Egyptian population, the most prevalent barriers to telehealth utilization were communication barriers (97.6%), lack of confidence in health professionals (77.6%), technological limitations (72.5%), the need for physical examination (25%), and privacy concerns (10%). Regarding hospital readiness, 42% of governmental hospitals were not taking any initiative to implement telehealth services, and 15.4% were at the beginner level, meaning that some steps had been taken. However, the hospital was still far from being able to implement telehealth services. In contrast, private hospitals were either at the beginner or advanced level.


Although the use of telehealth services in Egypt has increased, there is a need to address the barriers to public utilization and improve hospitals’ readiness to implement telehealth services to enhance public usage.

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Assessment of nurses’ knowledge of the prevention of hospital‑associated venous thromboembolism in a tertiary health institution in Nigeria
Patricia Obiajulu ONIANWA, Folashade Omobisi Mary AKANBI, Mary Oyenike AYORINDE, Oluwatosin Esther JOHN, Olufunke Olabisi ARE, Ogonna Eze OJERINDE, Sariyat Yetunde ALAKA
Journal of Integrative Nursing    2023, 5 (3): 210-215.   doi: 10.4103/jin.jin_10_23
Abstract20)      PDF(pc) (544KB)(3)      


This study assessed the level of nurses’ knowledge of the prevention of venous thromboembolism (VTE) in a tertiary health institution.

Materials and Methods: 

This descriptive cross-sectional study was conducted with 328 eligible respondents, selected using a random sampling method in a teaching hospital in Nigeria. A self-administered structured questionnaire was used to collect data on the basic knowledge, risk factors, and preventive measures of VTE.


Findings from the study revealed that 51.2% scored above the mean score of 28.6 ± 3.1. The educational status of the respondents had a significant influence on their knowledge of risk factors of VTE (F = 4.696, P = 0.031).


The overall knowledge of nurses is satisfactory, although the majority could not answer correctly questions on the administration of prefilled anticoagulants and identification of some key risk factors of VTE.

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To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study
Sonia GULATI, Hariprasath PANDURANGAN, Pulin Kumar GUPTA
Journal of Integrative Nursing    2023, 5 (4): 256-265.   doi: 10.4103/jin.jin_81_23
Abstract20)      PDF(pc) (651KB)(6)      

Objective: For people living with HIV (PLHIV), strict adherence to highly active antiretroviral therapy (HAART) is the key to effective treatment and retention in human immunodeficiency virus (HIV) care. There are many factors which promote or halt the antiretroviral therapy (ART) adherence practices. Therefore, the present study aimed to examine the HAART adherence levels and to explore patients’ views about barriers and facilitators to HIV treatment adherence.

Methods: Semi?structured interviews were conducted among 15 PLHIV at the ART clinic of Dr. Ram Manohar Lohia Hospital, New Delhi. Interviews were audio?recorded in the local Hindi language, and bilingual experts (English and Hindi) transcribed verbatim. Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis.

Results: Feeling of hopelessness, delayed ART initiation, difficult initial phase of ART, forget to take ART on time, fear of disclosure of HIV diagnosis, lack of privacy and negative social support, and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence. At the same time, commitment to raise and educate children, ART to increase life span, maintain oneself to be physically fit and healthy, only a single pill per day, very supportive counselors and health?care professionals, and hope to give birth to a healthy child were identified as facilitators of HIV retention.

Conclusion: Understanding patient’s perception about ART adherence, its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow?ups are of utmost importance to improve ART adherence during HIV patient care services.

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Prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department after the second wave of the coronavirus disease 2019 pandemic
Manisha MEHRA, Poonam JOSHI, Surya Kant TIWARI, Praveen AGGRAWAL, Kamlesh CHANDELIA, Srinithya RAGHAVAN
Journal of Integrative Nursing    2023, 5 (4): 273-279.   doi: 10.4103/jin.jin_80_23
Abstract18)      PDF(pc) (659KB)(7)      

Objectives: The present study aims to assess the prevalence and predictors of smartphone addiction and insomnia among nurses working in the outpatient department (OPD) after the second wave of the coronavirus disease 2019 (COVID?19) pandemic.

Materials and Methods: A descriptive, cross-sectional study was carried out among 117 OPD nurses between October and December 2021 using a purposive sampling technique. Two self-reported standardized scales, the Smartphone Addiction Scale-Short Version and Insomnia Severity Index were used. Kolmogorov–Smirnov test, Mann–Whitney U, and Kruskal–Wallis H test were used. Pearson’s correlation and Scatter plot were used to determine the relationship between the study variables. A stepwise multiple linear regression analysis was also performed.

Results: The majority of participants had slight smartphone addiction (78.6%) and suffered from sub-threshold to severe forms of insomnia (73.5%). A significant mild positive correlation was found between smartphone addiction and insomnia (r = 0.195, P < 0.05). Stepwise multivariate logistic regression analysis predicted factors such as female gender and exposure to smartphones for more than 5 years influencing smartphone addiction. A strong influence of exposure to the smartphone for more than 5 years was found on insomnia severity.

Conclusion: Smartphone addiction and insomnia were identified problems among nurses working in the OPD after the second wave of the COVID-19 pandemic, requiring an urgent need to identify and manage various factors responsible for smartphone addiction and insomnia such as female gender and years of exposure to smartphones.

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Postoperative pain assessment and management among nurses in selected hospitals in Benin City, Edo State, Nigeria
Timothy Aghogho EHWARIEME, Uzezi JOSIAH, Oluwaseun Oluwafunmilayo ABIODUN
Journal of Integrative Nursing    2023, 5 (3): 203-209.   doi: 10.4103/jin.jin_54_23
Abstract18)      PDF(pc) (661KB)(5)      


This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals, Benin City, Edo State, Nigeria.

Materials and Methods: 

A descriptive cross-sectional survey was adopted. The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities. The data were collected from the participants using the pretested structured questionnaire developed by the researcher.


Results showed that 66.2% of nurses had a poor level of knowledge on postoperative pain assessment. The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90. “Providing clean, calm, and well-ventilated ward environment” (3.69 ± 0.61) was the most used nonpharmacological method for postoperative pain management, followed by “distraction, relaxation, and guided imagery” (3.52 ± 0.50), “dressing, bandage, splint, and reinforce wound sites postoperatively” (3.39 ± 0.54), and “early ambulation/exercise” (3.20 ± 0.62). The most used pharmacological interventions were “acetaminophen” (3.63 ± 0.55), “topical anesthetic” (2.92 ± 0.62), “nonselective nonsteroidal anti-inflammatory drugs” (2.87 ± 0.43), and “mixed opioid agonist–antagonist” (2.56 ± 0.56).


There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting. It is, therefore, pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management, especially on nonpharmacological approaches among nurses.

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Upshots of health education among patients with type 2 diabetes mellitus: A field study in Mysuru
Deepak ANIL, D. Sunil KUMAR, Annaram RAVALI, Vijaylakshmi Rao VADAGA, Arun GOPI
Journal of Integrative Nursing    2023, 5 (4): 250-255.   doi: 10.4103/jin.jin_102_23
Abstract17)      PDF(pc) (664KB)(5)      

Objective: This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.

Materials and Methods: A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru, India from July to December 2022. Participants were assigned to two groups: intervention (n = 52) and control (n = 52), and their data were collected. The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed, whereas the participants in the control group were asked to continue their routine health checkups. The body mass index (BMI), weight, fasting blood sugar (FBS), knowledge about the disease, and behavior changes were recorded and compared between the two groups before and after 6 months.

Results: The mean FBS value, BMI and weight decreased significantly in the intervention group after 6 months (FBS: 164.79 ± 47.59 mg/dL vs. 141.92 ± 25.63 mg/dL, P < 0.001; BMI: 22.97 ± 3.75 kg/m2 vs. 22.62 ± 3.29 kg/m2 , P < 0.05; weight: 62.82 ± 11.92 kg vs. 61.54 ± 10.67 kg, P < 0.05). The posttest period also showed an improvement in physical activity, diet, and medication adherence in the intervention group compared to the control group (P < 0.05). The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test (P < 0.05).

Conclusions: The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before. The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.

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Conflict management styles of nurse managers and influencing factors in children’s hospital, Vietnam
Ha Manh TUAN, Tran Thi Hong HUONG, Le Viet TUNG
Journal of Integrative Nursing    2023, 5 (4): 266-272.   doi: 10.4103/jin.jin_103_23
Abstract17)      PDF(pc) (731KB)(5)      

Objective: This study aimed to describe the conflict management styles and identify factors affecting the conflict management styles of nurse managers.

Materials and Methods: A cross-sectional study was conducted by interviewing nurse managers with a questionnaire, including the Rahim Organizational Conflict Inventory-II Form B, used to assess an individual’s approach to conflict management across five styles: cooperating, competing, compromising, obliging, and avoiding.

Results: A total of 30 nurse managers participated in this study. The mean scores of the cooperating style were the highest at 4.3 ± 0.4, followed by a compromising style at 3.4 ± 0.5, an avoiding style at 3.1 ± 0.6, an accommodating style at 2.9 ± 0.7, and a competing style at 2.8 ± 0.8 (χ2 = 66.624, P < 0.001). The mean scores for avoiding style among bachelor’s degree nurse managers (3.2 ± 0.6) were higher than those of master’s degree nurse managers (2.7 ± 0.6) (P = 0.036). Nurse managers over 40 years old, holding a managerial position for ≥10 years, and frequent conflict handling rated higher mean scores for the cooperating style than their counterparts (P < 0.05).

Conclusion: The cooperating style was the most commonly used conflict management style among nurse managers. Factors affecting the conflict management style were age, education level, and experience in management and conflict handling. These findings are useful for developing interventions that enhance the competencies of nurse managers in conflict management.

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Latent tuberculosis infection in health‑care workers in the government sector in Brunei Darussalam: A cross‑sectional study
Nurin Jazmina Muhammad SYAFIQ, Ashishkumar Akshaykumar TRIVEDI, Alice LAI, Maria Pureza Aurelio FONTELERA, Mei Ann LIM
Journal of Integrative Nursing    2023, 5 (3): 197-202.   doi: 10.4103/jin.jin_18_23
Abstract15)      PDF(pc) (539KB)(3)      


Health-care workers (HCWs) are known to be at high risk for occupational biological hazards, and this includes exposure to mycobacterium tuberculosis (TB) which can result in either active or latent TB infection (LTBI). This study aims to provide an overview of the incidence of LTBI among HCWs in Brunei Darussalam, to examine associated risk factors, and to evaluate LTBI treatment compliance.

Materials and Methods: 

This is a retrospective cross-sectional study which was conducted using data from January 2018 to December 2021, on notified cases of LTBI in HCWs which identified 115 cases. Demographic data, underlying medical conditions, and compliance to treatment were assessed through reviews of their electronic health records.


The incidence of LBTI was 14.6/year/1000 HCWs. The incidence rate reached a high of 24.6/1000 in 2020, and majority of cases were in the older age groups. There was good treatment acceptance and compliance (82.6%), and this was observed to be significantly higher in females than males (P = 0.02).


This study showed an average incidence of LTBI of 14.6/1000 HCWs over 4 years and high LTBI treatment acceptance (82.6%) and compliance. Emphasis on infection prevention and control measures in health-care settings and actions to increase awareness of LTBI are crucial interventions toward reducing the burden of LTBI.

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Herbs and management of hypertension: Claims, criticism, and challenges
Oluwakemi Elizabeth ADEOLA, Oluwaseyi Abiodun AKPOR, Oghenerobor Benjamin AKPOR, Modupe Motunrayo ADAMOLEKUN, Olusola Bolaji ADEWALE
Journal of Integrative Nursing    2023, 5 (3): 216-222.   doi: 10.4103/jin.jin_86_22
Abstract14)      PDF(pc) (520KB)(4)      
Hypertension (HTN) is one of the most common chronic diseases affecting over 30% of the adult population globally, with a growing incidence rate. This article aims to identify the commonly used herbs for HTN treatment and examine their claims, criticisms, and challenges. It further aims to provide useful recommendations regarding the use of herbs for HTN treatment. HTN complications, such as coronary heart disease, stroke, peripheral vascular disease, vision impairment, and renal failure can result in morbidity and mortality. The high cost of conventional medications, which sometimes may not even be available or easily accessible with their unfavorable side effects as well as taking more than one pill per day, has led hypertensive patients, particularly those in rural areas, to explore alternative treatments such as herbal therapies. It is crucial to determine the different modes of action, doses, safety, and efficacy of herbal remedies used in combination with conventional medications to improve treatment adherence and enhance patient outcomes.
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Scope of technology in health care, special focus on nursing
Adil Mudasir MALLA, Ulfat AMIN
Journal of Integrative Nursing    2023, 5 (4): 300-310.   doi: 10.4103/jin.jin_92_23
Abstract13)      PDF(pc) (918KB)(6)      
Integrating artificial intelligence (AI) into health care reshapes nursing practices and education, enhancing patient care and clinical processes. This article discusses the transformative potential of AI in nursing, from streamlining documentation and diagnosis using AI applications to the evolution of nursing. The utilization of AI in primary care through automated communication strategies and the emergence of humanistic AI solutions are explored. As nurses adapt to AI?driven health-care technologies, balancing present needs with future demands becomes imperative. AI provides substantial advantages, but it's crucial to address challenges to ensure the successful integration of technology in healthcare and maintain the delivery of high-quality patient care in our tech-driven healthcare environment.
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The role of nurses in the prevention of cervical cancer: Cervical screening, an unkept promise by the majority of women in Nigeria
Mary Opeyemi ADIGUN, Deborah Tolulope ESAN, Benedict Tolulope ADEYANJU, Babatunji Emmanuel OYINLOYE
Journal of Integrative Nursing    2023, 5 (4): 311-316.   doi: 10.4103/jin.jin_65_23
Abstract12)      PDF(pc) (510KB)(7)      
Cervical cancer remains a major public health problem accounting for continuous female death in developing countries. Cervical cancer is the second most common cancer in women globally with an estimated number of 500,000 new cases of cervical cancer and 273,000 mortalities annually. Cervical screening is the best cancer screening test in the history of medicine and most cost-effective of all medical screening tests. The study review aimed to highlight methods of cervical cancer prevention, identify the uptake of cervical screening among women, and explain the role of nurses in uptake of cervical screening. Cervical cancer is preventable and easily treatable if it is detected at early stages, but poor information on prevention and access to screening and treatment contributes to 90% of deaths. In the developing countries such as Nigeria, a large proportion of cervical cancers are diagnosed in advanced stages, with poor rates of survival. The three main methods for preventing cervical cancer are through primary prevention (human papillomavirus vaccination and health education), secondary prevention (cervical screening, early detection of precancerous lesions, and treatment), and tertiary prevention (measures to slow the progression or recurrence, surgical removal, radiotherapy, and chemotherapy). Nurses can help improve the acceptability of this neglected promise by focusing on health education on cervical screening and vaccination in prenatal clinics and infant welfare clinics where there are more women. Inclusion of cyberspace could also serve as a successful and popular platform for this health teaching. All nurses/midwives must preach and fervently work toward the WHO 90–70–90 plan for eradicating cervical cancer.
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Nonpharmacological pain management practices among nurses working in multiple centers in Saudi Arabia: A cross‑sectional study
Afaf Mufadhi ALRIMALI, Noran Mohammad AL‑HAMAD, Faisal Hamoud ALMAZEANI, Mona Dahi ALHARBI
Journal of Integrative Nursing    2023, 5 (4): 292-299.   doi: 10.4103/jin.jin_94_23
Abstract12)      PDF(pc) (654KB)(6)      

Objective: The aim of the study was to investigate the prevalence, and determinants, of nonpharmacological pain management practices among nurses in multiple settings.

Materials and Methods: A cross-sectional examination was conducted involving 324 nurses from 16 hospitals in Hai’l, Saudi Arabia. Participants completed a self?reported survey utilizing established tools to assess the frequency of nonpharmacological pain management interventions utilization and identify associated barriers. Data analysis was performed using SPSS version 29.0.

Results: Nonpharmacological pain management practices were found to be utilized “sometimes,” with a score of 2.89 ± 0.48. Commonly employed techniques included placing patients in comfortable positions and providing a tranquil environment. Gender was the sole demographic factor significantly affecting the use of these techniques (P < 0.001), with female nurses demonstrating higher utilization. Barriers to implementation varied based on the hours of recent pain management education (P = 0.004), with prevalent barriers including nurse shortages, multiple responsibilities, heavy workloads, and nurse fatigue.

Conclusion: The study reveals moderate utilization of nonpharmacological pain management approaches, primarily focusing on patient positioning and creating a calm environment. Female nurses exhibited higher adoption rates of these techniques. Barriers to implementation, such as nurse shortages and heavy workloads, were influenced by recent pain management education. Consequently, enhancing education and fostering supportive work environments are crucial for surmounting these barriers and promoting pain management awareness among nurses.

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Occupation‑related airborne diseases: Management and prevention of tuberculosis among nurses working in Ekiti State University Teaching Hospital
Olaolorunpo OLORUNFEMI, Damilola SAMUEL, Joseph Adekunle ADEBIYI, Adewole Peter AKINDIPE, Wakeel Adelani TIJANI
Journal of Integrative Nursing    2023, 5 (4): 280-285.   doi: 10.4103/jin.jin_75_23
Abstract12)      PDF(pc) (535KB)(5)      

Objective: More health workers die from infectious diseases such as tuberculosis (TB) than from any other infectious agent, so the current study is designed to assess TB treatment and preventive measures as they relate to nursing care practice.

Materials and Methods: A cross-sectional study was conducted among 82 nurses from December 2022 to January 2023. The data were collected through a self-developed questionnaire and analyzed by frequency table and analysis of variance (ANOVA) statistics.

Results: The researchers found that nurses have sufficient knowledge on Infection Prevention and Control (IPC) policy, but not all nurses follow this management protocol, and the reason for their action is addressed in this study. The management and preventive measures used by the participants were identified as: proper cough etiquette/hygiene, working in a well-ventilated area, use of mask, appropriate disposal of used items and so on was reported. Moreover, this study also discovered that there is a positive correlation between nurses who had received training in IPC policy and their use of airborne preventive measures for TB patients (F = 1.87, P = 0.002) as well as a positive correlation between the availability of resources and their adherence to the proper use of airborne preventive measures when caring for TB patients (F = 1.96, P < 0.001).

Conclusion: We proposed infection and control training for nurses and adequate equipment supplies to the TB ward which are required in quick TB diagnosis, and must be carried out on a regular basis by health-care personnel, for efficient nursing practice. Ensuring proper safety equipment and isolation units should be available and assessable for nurses or other health workers showing sign or symptoms of TB. Similarly, it is necessary for government to put in place the control and regulations that will safeguard nurses and mandate them to adopt TB prevention protocols, which will aid in lowering the prevalence of TB among nurses.

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Evaluation of the etiologies and rehabilitation status of patients with blindness: A prospective observational study
Sarmistha DAS, Pankaj Kumar HALDER, Suchidipa RAY, Akholu VADEO, Kallol PAUL, Sneha SARKAR
Journal of Integrative Nursing    2023, 5 (4): 286-291.   doi: 10.4103/jin.jin_97_23
Abstract11)      PDF(pc) (930KB)(5)      

Objective: Preventive measures and appropriate rehabilitation are important in reducing the social burden of blindness. This study was to evaluate the etiologies, proportions, and level of rehabilitation for patients with blindness.

Materials and Methods: A prospective observational study with 1000 visually impaired patients was conducted. The data regarding age, gender, socioeconomic status (SES), etiologies, curable or incurable blindness (IB), treatments, awareness, and state of rehabilitation were collected and reviewed.

Results: The ratio of curable to IB was 0.82:1. The proportion of blindness rises after 40, even while the proportion of curable blindness (CB) increases after 60. The male–female ratios were 1.25:1 and 1:1.66 in the cases of CB and IB, respectively. On the other hand, the male–female ratio for childhood blindness was 1.66:1. Cataracts (78.22%) were the most common cause of CB, whereas diabetic retinopathy (24%), corneal opacity (17.5%), and trauma (12.4%) were causes of IB. Patients with illiteracy, low SES, and female gender were more likely to develop IB. There were low enrollment rates at the blind school and poor rehabilitation, mainly because of a lack of knowledge.

Conclusion: Diabetic retinopathy, corneal opacity, and trauma are the major causes of IB. IB and poor rehabilitation were more profound in women and were associated with illiteracy, low SES, and a lack of awareness.

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Level of stress among nurses and their adopted coping strategies
Alijungla JAMIR, Angouziia Lily PIKU, Boli Vihoyi ZHIMOMI, Christie KOYU, Diana CHOREI, Deimaia Emi LYNGDOH, Bendangmenla AO
Journal of Integrative Nursing    2023, 5 (3): 161-166.   doi: 10.4103/jin.jin_59_23
Abstract11)      PDF(pc) (713KB)(8)      


This study was aimed at identifying the nurse’s level of stress and the coping mechanism adopted by them.

Materials and Methods: 

A descriptive study was done to assess the level of stress and the coping strategies adopted by the nurses in a secondary hospital in North East India, Nagaland. A total enumerative sampling technique was used to select 94 samples for the study. The Nursing stress scale (NSS) by Gray-Toft and Anderson 1981 was used to assess stress, and the Ways of Coping Questionnaire was used.


Of 94 samples, 68 (72.34%) had a mild level of stress, 25 (26.59%) had a moderate level of stress, and only 1 (0.06%) had a severe level of stress. Thirty-one (32.97%) used minimal coping strategies, and 63 (67.02%) used moderate coping strategies. There was no significant association between the stress level and selected demographic variables such as age, marital status, and years of experience (all P > 0.05). A significant association was found between the stresses of nurses and qualification of nurses (χ2 = 4.10, P = 0.04).


The study reveals that most nurses had mild levels of stress. Most nurses use moderate coping strategies to relieve their stressors at work. Thus, there is a need to emphasize the importance of using effective coping strategies for nurses to alleviate their stresses and anxiety in their workplace and even in their personal lives.

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A systematic review of the efficacy of traditional Chinese medicine retention enema in the treatment of ulcerative colitis
Jiaji LI, Ling TANG, Ye LI, Jingjin XU, Jing ZHANG
Journal of Integrative Nursing    2024, 6 (1): 55-61.   doi: 10.4103/jin.jin_115_23
Abstract11)      PDF(pc) (1048KB)(0)      

The objective of this study is to summarize the efficacy and safety of traditional Chinese medicine (TCM) enema in the treatment of ulcerative colitis (UC). The randomized controlled trials on TCM enema intervention in the treatment of UC were searched in seven databases: PubMed, Embase, Web of Science, CBM, CNKI, Wanfang Database, and VIP Database from January 1, 2013 to June 6, 2022, and the data were analyzed using RevMan 5.3 software. A total of 18 studies involving 1514 UC patients were included. Meta analysis results showed that compared with conventional Western medicine, Chinese medicine enema had a significant effect on UC, and the clinical effective rate of the experimental group using Chinese medicine enema was 4.45 times that of the control group using conventional Western medicine (odds ratio = 4.45, 95% confidence interval [3.27, 6.06]). Therefore, Chinese medicine enema is effective in the treatment of UC, and can significantly reduce related symptoms.

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Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer: A 1-year longitudinal study
Gonca Hanedan USLU, Aydanur AYDIN, Ayla GÜRSOY
Journal of Integrative Nursing    2024, 6 (1): 15-21.   doi: 10.4103/jin.jin_122_23
Abstract10)      PDF(pc) (645KB)(0)      

Objective: The objective of this study was to investigate the frequency of acute and late toxicities, as well as changes in the quality of life (QOL) for breast cancer patients following radiotherapy (RT).

Materials and Methods: A total of 108 breast cancer women were recruited for this prospective study. Data were collected at various intervals; prior to, and 1, 3, 6 months, and 1 year after radiation therapy. The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer (EORTC) criteria. Our secondary outcome was QOL, measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale. We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.
Results: The early toxicities that are most commonly experienced include pharyngeal, skin, and mucous membrane toxicity. Late toxicities frequently involve skin and submucosal toxicity. To measure patient functionality, all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT. Symptoms of the patients, which were included in the QOL symptom scale, decreased during the follow-up period, except for fatigue; however, changes in pain, insomnia, and loss of appetite did not significantly change. We identified the analogous symptom profiles in Edmonton. Although patients’ overall health scores declined in the 1st and 3rd months after radiotherapy (RT), they rebounded at 6 and 12 months.
Conclusion: For breast cancer patients, RT did not adversely affect functional capacity or exacerbate symptoms, but persistent fatigue did increase during the observation period. Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.
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Association of spiritual well-being with quality of life among undergraduate nursing students
Journal of Integrative Nursing    2024, 6 (1): 49-54.   doi: 10.4103/jin.jin_149_23
Abstract9)      PDF(pc) (558KB)(0)      

Objective: The study was conducted with the aim of determining the spiritual well?being (SWB) of nursing students and its association with quality of life (QOL).

Materials and Methods: A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa, Pakistan, using convenient sampling techniques. A Spiritual Health and Life-Orientation Measure (SHALOM) questionnaire for SWB and K-27 QOL (K-27 QOL) instrument were used for data collection that contains three parts.
Results: The number of female participants was in the majority (50.4%) compared to male nurses (49.6%). The overall mean score of SWB of the students was 3.79 ± 0.48, while the mean K-27 QOL score was 3.73 ± 0.57. There were significant differences between the groups of gender (P = 0.001), while no significant difference within the groups of semester (P = 0.061) and college status (0.285). In QOL, there were significant differences within the groups of semester (P = 0.000) and college status (P = 0.036) while no significant difference in gender category (P = 0.480). SHALOM score is positively and moderately correlated with QOL score (r = 0.597, P < 0.05).
Conclusion: Spiritual practices are one of the important factors that are associated positively with QOL, therefore to enhance the QOL, it will require spiritual practices.
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Transcultural adaptation of Odia version of health-related kidney disease and quality of life-36 instrument
Rashmimala PRADHAN, Pravati TRIPATHY, Debaprasad KAR
Journal of Integrative Nursing    2024, 6 (1): 41-48.   doi: 10.4103/jin.jin_112_23
Abstract8)      PDF(pc) (605KB)(0)      

Objective: The study objective was to translate, validate, and test the reliability of the original kidney disease and quality of life-36 (KDQOL-36TM) instruments in Odia.

Materials and Methods: A cross-sectional design with a purposive sampling technique was used. According to RAND Corporation guidelines, initially, the items of the KDQOL-36TM questionnaires were translated into Odia by two independent, bilingual, professional translators, and then back?translated to English, followed by tryout and field testing. The experts validated the KDQOL-36TM instrument review committee for review related to kidney health conditions. The tool was implemented among 180 patients undergoing “maintenance” hemodialysis. The following tests evaluated reliability and validity: test–retest reliability with Cronbach’s alpha correlation (stability), (reliability) internal consistency, and contents validity index.
Results: The Cronbach’s alpha value and intraclass correlation coefficient (ICC) score of all five domains, namely “physical component summary, mental component summary (MCS), the burden of kidney disease, symptoms and problems of kidney disease, and effects of kidney disease” of both KDQOL-36TM English and Odia (KDQOL-36-ETM and KDQOL-36-OTM) version, recommended excellent homogeneity. A high positive correlation (r = 0.998) was found between the Odia version of KDQOL-36TM and the English version KDQOL-36TM questionnaire. The ICC score ranges from 0.889 to 0.997 at a 95% confidence interval for test–retest reliability, and Cronbach’s alpha was 0.832.
Conclusion: This study explores the Odia version of KDQOL-36TM psychometric properties, depicted at an acceptable level of internal consistency. The KDQOL-36-OTM instrument is a valid and reliable tool for assessing the kidney disease-related quality of life in Odia-speaking hemodialysis patients.
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Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients
Mohammed Elsayed ZAKY, Shimaa Magdi FARGHALY, Osama Mohamed Elsayed RAMADAN, Rehab M. ABDELKADER, Mostafa SHABAN
Journal of Integrative Nursing    2024, 6 (1): 22-28.   doi: 10.4103/jin.jin_141_23
Abstract8)      PDF(pc) (618KB)(0)      

Objective: Rheumatoid arthritis (RA) requires comprehensive management. Structured nursing protocols may enhance outcomes, but evidence is limited. This study evaluated the effect of a structured nursing protocol on RA outcomes.

Materials and Methods: In this one-group pre-post study, 30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education, psychosocial support, and self-management promotion. Assessments included clinical evaluation of joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and patient-reported Arthritis Self-Efficacy Scale (ASES), Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and Hospital Anxiety and Depression Scale (HADS).
Results: The study demonstrated significant improvements in both clinical- and patient-reported outcomes. Joint count decreased from 18.4 ± 4.2 to 14.2 ± 3.8 (P < 0.001), ESR from 30.1 ± 6.8 mm/h to 25.5 ± 6.8 mm/h (P < 0.01), and CRP levels from 15.2 ± 3.6 mg/L to 11.8 ± 2.9 mg/L (P < 0.01) postintervention. Patient-reported outcomes showed a marked increase in ASES score from 140 ± 25 to 170 ± 30 (P < 0.001) and reductions in HAQ from 1.6 ± 0.4 to 1.3 ± 0.3 (P < 0.01), VAS pain score from 7.8 ± 1.7 to 6.2 ± 1.2 (P < 0.001), and HADS anxiety and depression scores from 11 ± 3 to 8 ± 2 (P < 0.05) and 10 ± 2 to 7 ± 1 (P < 0.05), respectively.
Conclusion: A structured nursing protocol significantly improved clinical disease activity, physical functioning, pain, self-efficacy, and emotional well-being in RA patients. A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.
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Oketani massage with jasmine oil improves breast milk production on postpartum days 1–3
Ni Made Ratih Comala DEWI, Made Ririn Sri WULANDARI, Yupin AUNGSUROCH
Journal of Integrative Nursing    2024, 6 (1): 35-40.   doi: 10.4103/jin.jin_117_23
Abstract7)      PDF(pc) (1598KB)(0)      
Objective: This study aimed to determine the effect of Oketani massage with jasmine oil on improving breast milk production on days 1–3.
Materials and Methods: This preexperimental one-group pretest–posttest design was conducted with 44 eligible respondents, selected using an incidental sampling technique. Oketani massage with jasmine oil was conducted once a day for 3 consecutive days. A total of 44 respondents were selected with incidental sampling. Sufficient breast milk production was observed through the frequency of baby urination in 24 h, the frequency of baby defecation in 24 h, the baby’s weight, and the length of time the baby slept or remained calm after breastfeeding.
Results: Results showed that Oketani massage using jasmine oil impacted on increasing breast milk production in postpartum on days 1–3 (Z = 6.633, P = 0.000). The baby’s weight in 3 days was increased after intervention compared with intervention before (2858.25 ± 180.62 g vs. 2881.66 ± 180.96 g, t = 55.33, P = 0.000), the baby’s urination frequency was increased after intervention (4.55 ± 0.50 vs. 7.20 ± 0.70, t = 17.87, P = 0.000), the breastfeeding frequency has decreased (10.27 ± 1.42 vs. 8.82 ± 0.82, t = 6.94, P = 0.000), and the time of baby’s sleeping or calming state has increased (5.14 ± 6.46 h vs. 8.48 ± 10.24 h, t = 2.11, P = 0.041).
Conclusion: Oketani massage combined with jasmine oil has been shown to be effective on improving breast milk production on days 1–3.
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