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Browsing by Author "KC, Takma"

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    Adherence to Therapeutic Regimen in Diabetic Patients Attending a Tertiary Level Hospital
    (Institute of Medicine, 2020) Shrestha, Krishna D; KC, Takma; Ghimire, Rachana
    ABSTRACT Introduction: Adherence to treatment regimen among diabetes patients is very crucial for good glycemic control. Poor adherence is a widely recognized problem causing great impact on poor health outcomes and healthcare costs. Hence, this study was conducted to identify the adherence to prescribed therapeutic regimen among diabetic patients. Methods: A descriptive cross sectional research design was adopted. Data was collected purposively among 422 respondents attending at medical OPD in Tribhuvan University Teaching Hospital through interview using structured questionnaire. Analysis was done by descriptive and inferential statistics. Results: The study findings revealed good follow up adherence (57.8%). Adherence to medicine, diet and exercise were (28.5%), (16.1%) and (8.8%) respectively. Dietary adherence was associated with sex (p=0.03), educational level (p<0.001), occupation (p=0.04), attending diabetic counseling (p<0.001) and knowledge level (p<0.001). Exercise adherence was associated with sex, educational level, attending diabetic counseling, history of hospitalization and knowledge level (p<0.05). Medication adherence was associated with attending diabetic counseling (p=0.03). Follow up adherence was associated with education, occupation, attending diabetic counseling, duration of diabetes mellitus, frequency of follow up visit, and knowledge level (p<0.05). Moreover, respondents with good adherence to exercise (75.7%), medicine (63.3%) and follow up adherence (66%) had controlled fasting blood sugar level (p=0.01, p=0.03 and p=0.01 respectively). Conclusion: Adherence on diet and exercise was very low than other components among diabetes patients. So, it is recommended to focus on education especially on diet and exercise adherence which would be of great benefit in glycemic control. Keywords: Adherence, compliance, diabetic patient, treatment regimen
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    Age-Friendly Hospital Environments: Qualitative Exploration of the Senior Citizens and Caregivers’ Perspectives
    (Institute of Medicine, 2025) Shrestha, Krishna Devi; KC, Takma; Bista, Archana Pandey; Manandhar, Saraswati
    ABSTRACT Introduction: Age-friendly hospital environments, and quality care are very crucial for maintaining the health and well-being of older adults. Globally, despite the growing concerns of age-friendly environment, limited research exists on how the senior citizens and their caregivers perceive the hospital environments. Hence, this study explores their perspectives to inform improvements in providing age- friendly care and services. Methods: Descriptive phenomenological qualitative research was conducted at two tertiary-level hospitals in Nepal. A total of 28 participants were selected purposively and data were collected through in-depth interview using semi-structured interview guidelines and analysis was done by following Colaizzi's 7-steps of qualitative data analysis method. Results: Four main themes were extracted from the data analysis :‘need to access healthcare facilities;’ ‘urgent need for expansion of age-friendly hospital services;’ ‘the age-friendly physical environment; ‘need for information, education, and effective communication in an age-appropriate manner. Participants expected for the availability of transportation facilities, affordable/free hospital services, priority, and prompt services with adequate facilities. Additionally, participants emphasized on continuous presence of care givers, a separate, no queues and digital payment system in billing counter, timely information, a separate geriatric ward/OPD with age-friendly physical infrastructure with religious and spiritual support as essential elements of an age-friendly environment. Conclusion: This study highlights the need to create age-friendly hospital environment through development, implementation, promotion of policies, infrastructures, and age-sensitive approaches to enhance the well-being of senior citizens. Keywords: Age-friendly hospital environment; care givers; elderly-friendly hospital environment; health policies for senior citizens
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    Knowledge and Practice on Prevention of Complications of Diabetes Mellitus among Patients with Diabetes in a Tertiary Hospital
    (Institute of Medicine, 2019) Acharya, Om K; KC, Takma; Shrestha, Krishna D
    ABSTRACT Introduction Diabetes is a major contributing factor for overall health status, morbidity, mortality and quality of life. Adequate knowledge and sufficient practice can prevent many possible diabetic complications. Hence, the objective of this study was to find out the knowledge and practice regarding prevention of complications of diabetes among diabetic patients. Methods A descriptive, cross sectional design was carried out in Tribhuvan University Teaching Hospital Kathmandu (TUTH). A total 124 diabetic patients who came for follow-up in endocrine Out Patient Department were selected through purposive sampling technique by using pre-tested structured interview schedule during four weeks. Data was analyzed by using the descriptive and inferential statistics with the help of Statistical Package of Social Science (SPSS) version 16. Results The study findings showed that 24.2% respondents had adequate knowledge about complications . More than half of the respondents had sufficient practice (52.4%) regarding prevention of diabetic complications. Association between knowledge and selected variables showed that sex and education level tends to be significantly associated and regarding practice, area of residence and duration of illness were significantly associated (p<0.05). There was a statistically significant (p<0.001) and average positive relationship (r=0.605) was found between knowledge and practice. Conclusion The study concluded that though only few respondents had adequate knowledge, more than half of the respondents had sufficient practice regarding preventing complications. This finding suggests awareness program regarding prevention of compilcations of diabetes mellitus should be launched periodically to increase knowledge and sufficient practice on prevention of diabetic complications. Keywords:Diabetic complications, diabetes mellitus, knowledge, practice
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    Need of Specialized Courses in Advance Nursing Education in Nepal
    (Institute of Medicine, 2023) Rai, Lalita; KC, Takma; Adhikari, Raj D; Acharya, Devaka; Sharma, Muna; Gautam, Roshani; KC, Tulaza; Das, Indra K; Shrestha, Shristy
    ABSTRACT Introduction: Nursing specialization and certification of skill contribute nursing professionalism that improve nursing practice in an identified specific area within the entire field of professional nursing. Methods: A descriptive cross sectional survey was used for assessing the need of specialized courses in advanced nursing. Data was collected from January to March 2022 through an online survey among 354 nurses working in Nepal. Collected data was entered into SPSS version 16 and expressed by using descriptive statistics. Results: The findings showed that more than half (54.5%) of the participants were age group of 20-29, 99.4% were females, 50.3% had bachelor’s degree, 60.7% worked in government and 70.3% had working experience less than 10 years. Almost all (98.8%) felt importance of specialized courses in higher education and the needs of advanced courses (72.9%) and especially in critical care (53.1%) Almost all respondents (95.2 to 90.7%) perceived these courses increase self-esteem and morale, promote quality patient care, increase confidentiality and creditability, ensure competency, validate nurses’ knowledge and expertise, advancement of professional career ladder and clinical expert and increase professional accountability. Majority of them perceived (77.4%-57.6%) that specialty courses increase access to job-related power, obtain noticeable financial benefits and perform excellence services. Almost all (91.0%) of them perceived that it is beneficial to maintain professionalism. Conclusion: This study concluded that almost all graduate nurses felt specialty courses in masters degree for personal and professional development. Thus it is strongly recommended to initiate different specialized courses at the postgraduate level. Keywords: Advance nursing education; need; specialized courses

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