Browsing by Author "Mishra, Tulashi Adhikari"
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Publication Assertiveness of Nursing Professionals Working in a University Hospital of Nepal(Institute of Medicine, 2023) Shrestha, Romina; Mishra, Tulashi Adhikari; Banstola, Ratna S; Joshi, SaralaABSTRACT Introduction: To provide patients with appropriate treatment and foster therapeutic interactions, nurses must possess assertiveness. The study objective was to find out the assertiveness of nurses. Methods: In this cross-sectional study, 272 nurses were recruited using a proportionate stratified random sampling at Tribhuvan University Teaching Hospital (TUTH), Nepal. Assertiveness was measured with a self-administered questionnaire, 30-item Simple Rathus Assertiveness Schedule. Data analysis was done in SPSS version 16. Independent Sample t-test, Pearson Chi-square test, Fisher’s Exact test, and odds ratio were used to examine the association. Results: Among nurses, 192 (70.6%) were assertive with a mean assertiveness score of 18.1±14.7. There was a significant association of nurses’ assertiveness with their marital status (p = 0.02), nursing degree (p=0.03), professional designation (p=0.04), employment type (p= 0.03), and additional training (p=0.004). Nurses with bachelor-level nursing degrees were 1.8 times more assertive (95% CI = 1.05-3.07) than those nurses with certificate-level nursing degrees. Nursing officers were 2.1 times more assertive (95% CI = 1.02 – 4.2) than staff nurses. Further, permanently employed nurses were 2.63 times more assertive (95% CI = 1.35-5.12), and nurses who received additional training were 2.2 times more assertive (95% CI = 1.29-3.83). Conclusion: More than two-thirds of nurses working in the university hospital were assertive. Nurses with bachelor-level nursing degrees, with professional designation as “nursing officers”, with permanent employment, and those who received additional training were more assertive. These things should be taken into consideration by the hospital administration to increase assertiveness among nurses. Keywords: Assertiveness, nurses, university hospitalPublication Burden of Care Among Mothers Having Children with Congenital Heart Diseases(Nepal Paediatric Society (JNPS), 2020) Sharma, Nita; Sharma, Pratima; Mishra, Tulashi AdhikariAbstract: Introduction: Congenital Heart Disease (CHD) is a problem with structure and function of the heart that is present at birth. Children with CHD require special care, treatment and follow up for a number of common conditions which may be quite straining to the care givers. The objective of the study was to find out the burden of care among mothers having children with CHD. Methods: This descriptive cross-sectional study was carried out in a cardiac centre of Nepal. A total of 95 mothers having children with CHD attending outpatient department of our institute were selected as the sample for the study using non-probability purposive sampling technique. A semi structured interview questionnaire consisting of the Modified Caregiver Strain Index was used to assess the burden of care among mothers having children with CHD. Frequency and percent were used to describe the variables and chi- square test at 0.05 significance level was used to analyse associations. Results: Most (77.9%) of the mothers were regularly strained to find that their children’s health condition was deteriorating due to CHD. Nearly half (44.2%) of the mothers always had financial constrain while giving care to the child, nearly half (40%) of the mothers had done emotional adjustments to take care of their children with CHD, another two-fifths (28.4%) of the mothers sometimes had disturbed sleep and almost half (46.3%) of the mothers were always upset due to some behaviour of their child with CHD. Half (50.5%) of the mothers had high level of burden of care. Statistically significant association were found between age of the mother and level of burden of care (p value = 0.05). Similarly, the type of family (p value = 0.005), age of the children (p value = 0.000) and type of CHD (p value = 0.002) were significantly associated with the level of burden of care among the mothers. Conclusion: The study concluded that mothers tend to feel less burden of care as the child grows older, mothers having children with cyanotic heart disease tend to experience more burden of care. Mothers of less than thirty years of age and living in a joint family also experience more burden of care.Publication Burden of Care among Mothers Having Children with Down Syndrome(Nepal Health Research Council, 2022) Mishra, Tulashi Adhikari; Pandey, Kabita; Bhujel, Bishnu; Adhikari, ShovaAbstract Background: Down syndrome is the most common chromosomal disorder associated with mental retardation. Parents who are the primary caregivers of a child with a disability face numerous challenges in their day-to-day life. The objective of the study was to find out the burden of care among mothers having children with down syndrome. Methods: A descriptive cross-sectional study was carried out among 96 mothers having down syndrome children enrolled in the Down Syndrome Society, Nepal. Purposive Sampling technique was adopted for data collection. The Modified Caregiver Strain Index tool was used to collect data through interview. Data were collected from June 14, 2021 to August 1, 2021, which was analyzed by using descriptive and inferential statistics. Results: Findings revealed that majority of the mothers (77.1%) had high level of burden of care. Majority (89.6%) of the mothers involved in the study were always overwhelmed about their child’s conditions. More than half (55.2%) of the mothers were always financially strained in care giving, 57.3% had always done work adjustments and 60.4% of mothers always had emotional adjustments to be made. Similarly, 53.1% participants always felt that care giving was a physical strain. Burden of care was significantly associated with the age of delivery (p value= 0.008). Conclusions: The study concludes that mothers having children with down syndrome tend to have high level of burden of care and it is associated with the age at delivery. Therefore, health care providers including concerned authority are recommended to conduct different programs to support the caregivers in order to reduce their burden as well as to raise awareness program related to preventive measures of down syndrome in community. Keywords: Burden of care; down syndrome; mothersPublication Burden of Care among Mothers Having Children with Thalassemia(Institute of Medicine, 2022) Bhujel, Bishnu; Mishra, Tulashi AdhikariABSTRACT Introduction: Thalassemia, an inherited disorder is characterized by reduction in the ability of the body to synthesize hemoglobin. Though care giving is a normal parental duty, providing lifelong care to thalassemic children may increase burden among parents. The objective of this study was to find out the burden of care among mothers having thalassemic children. Methods: This descriptive cross-sectional study was carried out among 100 mothers attending a Thalassemia day care center in Kathmandu, Nepal. Non-probability purposive sampling technique was used to collect data through interview using Zarit Burden Interview scale. Results: Findings revealed that out of 100 mothers, 19% had little or no burden, 43% had mild level of burden of care, 34% had moderate burden of care and 4% had severe burden of care. It was found that 43% of the mothers frequently felt that child is depended upon her, 20% of the mothers, frequently felt stressed from caring their children. 35% of the mothers frequently felt that money is insufficient to care for their child. Statistically significant association was found between level of burden with economic status (p=0.002) and place of residence (p=0.03). Conclusion: The study concludes that mothers face burden of caring the child having thalassemia. Burden of care among mothers tends to be influenced by the family economic status and residence. This burden should be minimized by health personnel through proper counseling and support to mothers of thalassemic children. Keywords: Burden of care, mothers, thalassemia, thalassemic childrenPublication Effectiveness of Video-Assisted Distraction Technique in Reduction of Pain Among Preschool Children Undergoing Vein Puncture(Nepal Paediatric Society (JNPS), 2023) Mishra, Tulashi Adhikari; Subedi, AasthaAbstract: Introduction: Vein puncture is an invasive but common procedure for children, often accompanied by pain, fear and anxiety and refuse to cooperate. Distraction technique is one of the non-pharmacological methods of controlling pain. The objective of this study was to find the effectiveness of video assisted distraction technique in reduction of pain among preschooler children. Methods: Quasi experimental study was conducted in Bharatpur Hospital, Chitwan, Nepal. 108 preschooler children consisting of 54 children in each experimental and control group selected by non-probability purposive sampling technique were enrolled in the study. Structured pain scale was used to collect data in both groups. Animated cartoon video was shown only to experimental group five minutes prior to until the vein puncture was over. Data analysis was done using descriptive statistics and inferential statistical tests. Results: In experimental group, 59.2% had moderate pain whereas 68.5% in control group had severe pain. The pain score of experimental group was significantly lower than that of control group at p = 0.05 with the mean value of experimental and control group 6.85 ± 0.79 and 7.25 ± 0.87 respectively. Conclusions: Distraction is an effective technique for children undergoing vein puncture in order to alleviate pain level during vein puncture