Browsing by Author "Pun, KD"
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Publication Anxiety on Primigravid Women Attending Antenatal Care: A Hospital Based Cross-sectional Study(Kathmandu University, 2018) Shrestha, S; Pun, KDABSTRACT Background High levels of anxiety during pregnancy have adverse effects on mother and baby. Objective To assess anxiety on primigravid women attending Antenatal Care. Method Analytical cross-sectional study was carried out on the primigravid women attending Antenatal Care out-patient department of Dhulikhel Hospital. Perinatal Anxiety Screening Scale (PASS) was used to assess anxiety on 502 women. Data were collected through face-to-face interview using Systematic Random Sampling Technique from May 2017 to December 2017. Chi-square test was applied to test the association between selected variables. All p- values less than 0.05 were considered statistically significant. Result The mean (± Standard deviation [SD]) age of the participants was 23.17±3.9 years. More than half (57.6%) of the women were from the age group 20-25 years. Just above two-fifth (41.4%) of the participants were in the third trimester of pregnancy. Out of 502 pregnant women, nearly half (46.4%) of them were at high risk of anxiety. High risk of anxiety was significantly associated with age and type of family. However significant associations were not seen between high risk of anxiety during pregnancy and residence, educational status, occupation, husband’s occupation and gestational period of women. Conclusion The high risk of anxiety on primigravid women was quite up. Anxiety during pregnancy was more likely to fall on younger women (age <20 years) and joint families in comparison to those women from age twenty and above and nuclear families respectively. KEY WORDS Antenatal care, Anxiety, Primigravid womenPublication Knowledge, Perception and Confidence in Performance on Infection Prevention and Control Measures among the Nursing Students(Kathmandu University, 2023) Shrestha, S; Cho, Y; Bhuju, C; Cha, K; Chung, M; Pun, KDABSTRACT Background Healthcare-associated infections increase the patients’ hospital stay, morbidity and mortality. It is important that professionals including students acquire knowledge on infection and acquire skills regarding preventive measures. Objective The objectives of this study were to assess the knowledge, perception and confidence on infection prevention and control measures and to find the correlation between variables among nursing students. Method A cross-sectional descriptive study was conducted among 163 nursing students where a purposive sampling method was used to collect data using the self- structured questionnaire via emails. The questionnaire contained four parts; part I: demographic characteristics, part II: knowledge (40 items), part III: perception (42 items) and part IV: confidence in performance (42 items) on infection prevention and control. Data was analyzed using descriptive and inferential statistics where analysis of variance using Scheffe’s post hoc test and Pearson’s correlation test were used. Result Overall knowledge of the participants was fair (71%). They had good knowledge in general principles (85%) but notable poor knowledge in waste management (2%). There was a statistically significant difference in the knowledge among different levels of the students. A static correlation was found between the knowledge and confidence in performance whereas, perception was highly correlated with the confidence in performance of the participants. Conclusion Based on the findings of this study, it can be concluded that the students had fair level of knowledge regarding infection control measures. This study recommends the revision of nursing curriculum and mandating a standardized infection control curriculum across all schools of nursing in the country to improve the knowledge and practice. KEY WORDS Healthcare associated infections, Infection control, Knowledge, Nursing studentsPublication Outcomes Of Adolescent Pregnancy at Kathmandu University Hospital, Dhulikhel, Kavre(Kathmandu University, 2011) Pun, KD; Chauhan, MABSTRACT Background Adolescence Pregnancy is a social problem worldwide with serious implication of maternal and child health. This study purposed to compare the maternal and neonatal outcome of the teenage mothers (15- 19 years) with that of the young mothers (20-24 years) to determine if adolescent pregnancies have increased risk of adverse outcomes. Objectives This st udy aims to find out the outcomes of adolescent pregnancy at Kathmandu Univeristy Hospital, Dhulikhel Hospital, KAvre. Methods Descriptive cross sectional study was done. The study included all primiparous mothers of age 15-19 (n=168) and 20-24 (n=401) recorded in the delivery record book of Dhulikhel Hospital from June 2007 to May 2008. Chi-square test and relative risk (RR) for subgroups of study population was examined using the SPSS version 10.0. Results The low birth weight baby among teenage mothers and young mothers were 28% and 26.7% respectively (p=0.572). The Relative risk of low birth weight among adolescent is 1.1 (0.75-1.684) times to that of young mothers at 95% confidence interval. Preterm birth was not associated with adolescence pregnancy (7% Vs. 11.5%, p=0.141). Normal delivery was the common mode of delivery among both groups (77.4% Vs. 74.6%). Among the neonatal complication, newborns of adolescents had greater neonatal complications than newborns of the young mothers (17.2% Vs 16.7%). Maternal complication like antepartum hemorrhage (2.4% Vs. 1.7%) and postpartum hemorrhage (0.6% Vs. 0.2%) was higher among adolescents. Conclusions Low birth weight, common neonatal complication, antepartum hemorrhage and postpartum hemorrhage are found more in adolescent group, however statistically insignificant. KEY WORDS Adolescent, Outcome of pregnancy, primiparous, teenage mothers, Young mothersPublication Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital(Kathmandu University, 2008) Singh, R; Bhandary, S; Pun, KDAbstract Background: Peripheral intravenous catheter-related phlebitis is a common and signi cant problem in clinical practice. This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to de ne the possible factors associated to its development. Materials and methods: Prospective observational study was carried out on 230 clients who were under rst time peripheral infusion therapy during two months period: September – October, 2007. Peripheral infusion site was examined for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis. SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC curve were used to draw the statistical inferences. Results: Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm, IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of catheter insertion. Conclusion: Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a signi cant problem. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>= 36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 - 40 years. Therefore more attention and care are needed in these areas by the care provider. Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal.Publication Prevalence and Associated Factors of Cesarean Section in Dhulikhel Hospital, Kathmandu University Hospital(Kathmandu University, 2022) Acharya, R; Singh, B; Nepal, J; Thapa, P; Pandey, C; Pandey, J; Shrestha, S; Khan, A; Pun, KDABSTRACT Background The Cesarean Section (CS) is a major obstetric life-saving procedure used to avoid pregnancy and childbirth complications. Cesarean sections are becoming more popular across the world, as well as in Nepal. Objective To assess the prevalence of cesarean section and its associated factors among women in Dhulikhel, Nepal. Method A cross-sectional study was conducted where 1246 pregnant women of age 15-45 years, admitted and delivered in hospital, were selected through purposive sampling technique and interviewed using structured questionnaires in Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal. Result The prevalence of cesarean section among women was 39.7% where the most common indication was previous cesarean section with scar tenderness, 27.9%. Half of the participants, i.e. 50.6%, were primigravida. Majority of women, 97.5% had done their antenatal checkup and among them 74.8% had their checkup in Dhulikhel Hospital, Kathmandu University Hospital. Most of them, i.e.76.2% had emergency cesarean section and 69.5% had primary cesarean section. Women of the age group 30-45 years (AOR=2.23) and women with higher secondary education level (AOR=2.03) were two times more likely to perform cesarean section. Women involved in service (AOR=1.37) and business (AOR=1.23) had greater odds of performing cesarean section than homemakers. Women giving birth to infants weighing 3.51- 5.00 kg were more likely to perform cesarean section (AOR=1.33). Conclusion The prevalence of cesarean section is noticeably high where the educated, employed and higher aged women are more inclined to cesarean section. More obstetric factors could be explored to determine the rise in cesarean section in Nepal which can help in decision making for clinicians. KEY WORDS Cesarean section, Dhulikhel hospital, PrevalencePublication Violence Exposed Nepalese Pregnant Women have an Accepting Attitude to Domestic Violence and Suffer from Emotional Distress(Kathmandu University, 2023) Pun, KD; Bjørngaard, JH; Schei, B; Darj, E; The ADVANCE Study GroupABSTRACT Background Violence against women and girls is frequent, a third of all women is estimated to experience violence in their lifetime and mostly by an intimate partner. Women in Southeast Asia are most affected, and previous studies in Nepal found that one in five women had experiences of domestic violence, including being afraid of someone in the family. Objective To investigate women’s attitudes to domestic violence and their emotional distress, in a specific group of pregnant women. Method Validated questions from the WHO multi-country study on women’s health and experiences of domestic violence, and questions from the Hopkins Symptom Checklist (HSCL-5), measuring depression and anxiety, were used. Women could answer anonymously by hearing questions in a headset and touching a tablet screen, for ‘yes’ or ‘no’. Result In total 1011 pregnant women participated in the research and 240 women admitted being exposed to domestic violence (23.7%). These women had a more accepting attitude to violence compared to non-violence exposed women. They agreed more that the husband had good reasons to hit his wife, if she does not complete the household work to his satisfaction, she disobeys or refuses to have sex with him. Violence exposed women also reported more emotional distress and subsequently reduced wellbeing. They admitted worrying too much, feelings of hopelessness, feeling blue, fearful, or nervous. Conclusion The present study found that the pregnant Nepali women having an accepting attitude to violence suffer from emotional distress. KEY WORDS Attitudes, Domestic violence, Emotional distress, Pregnant women