Day 1 :
KK Women’s and Children’s Hospital, Singapore
Keynote: Patients’ readiness for early discharge with Radivac drain after mastectomy or wide local excision with axillary clearance
Time : 9:30-10:15
Ruey Pyng Ng is an oncology-trained Assistant Director of Nursing. She is responsible for breast care education and breast cancer counseling, as well as coordinating, directing and evaluating nursing care, including the involvement of nursing research and clinical trials in the department. She is also actively involved with the KK Alpine Blossoms Breast Cancer Support Group and her concern to provide encouragement and emotional support to the patients has generated an increased interest and participation by the patients. Teresa graduated from School of Nursing, Ministry of Health, Singapore, in 1991. Having completed her Certificate in Nursing, she proceeded to Australia and completed her degree in Health Sciences at the University of Western Sydney. She then proceeded to University of Canberra to do her Graduate Diploma in Nursing. She also possessed Master of Education and Master of Arts, and attended a two-month Clinical Nursing Fellowship with the NSW Breast Cancer Institute, Australia.
Statement of the Problem: Conventionally, surgical wound drains are removed within 7 to 10 days post operatively. Hospitalization could be shortened to 2-4 days if the patients are discharged with the drain and subsequently return for its removal at the outpatient clinic.
Aim: The aim of this study is to examine the readiness for early discharge with a drain amongst post-mastectomy or wide local excision with axillary clearance patients.
Methodology: A sample size of 100 patients, who were newly diagnosed with breast cancer and undergoing operation were recruited. A survey was conducted at an outpatient clinic where patients were attending the clinic for removal of drain. A returned questionnaire implied consent to the study. Descriptive data was reported.
Findings: 100 questionnaires were distributed, achieving a high response of 95% return rate. The results indicated that 75.5% were very motivated to be discharged with the drain, though 30.5% were worried about being discharged with the drain. Findings further showed that prior to discharge, 93.7% and 95.8% agreed that they were given demonstration on how to handle a Radivac drain and briefed about their discharge respectively and 90.5% were confident in managing the drain at home. 81.1% of the participants indicated that they were well-supported at home by the breast care nurses. Overall as high as 96.9% were satisfied with the early discharge planning and 93.7% were favorable about opting for early discharge with drain and 95.8% reported being well-prepared to care for themselves at home.
Conclusion & Significance: Early discharge with drain following breast cancer surgery is definitely feasible for patients provided they are well-prepared pre-and post-operatively and briefed on the expected outcome post-operatively. This study will aid in more in-depth review on surgical counseling to the patients.
Islamic Azad University, Dehaghan Branch, Iran
Time : 10:15-11:00
Babak Motamedi is a Professor of Nursing at the Department of Nursing, Islamic Azad University, Dehaghan Branch, Iran. He has done BS from Tehran University in 1988, and MS from Shiraz University of Medical Sciences in 1993. He received his PhD in Nursing Science from Azad University in 2001. From 1993 to 2002 he served as Vice president of University Research Center and from 2002 to 2010 he served as the Department Chair at Islamic Azad University, Dehaghan Branch, Iran. His research interest includes reducing health disparities through health promotion and disease prevention in underserved populations, the use of community-based participatory research methods, prevention and treatment of chronic diseases, violence control in health sector and clinical research ethics.
According to International Diabetes Federation, Diabetes mellitus is one of the most challenging and burdensome chronic diseases of the 21st century. There are now an estimated 4.6 million people with diabetes in Iran, which is 8.5% of the population. Critical theory emphasizes recognition of oppressive behavior and emancipation for a group of people. When applied to adolescents with diabetes, critical theory can discover alternatives to inappropriate and ineffective methods used for diabetes care delivery. Using a critical theory perspective, nursing care of adolescents with diabetes is examined in this article and suggestions for more positive and effective approaches are presented. Nurses have a great role in helping diabetes patients. This article exposes the contribution of the Critical theory to Nursing. Nursing as a caring profession involves an interpersonal relationship with patients.
Adolescents with diabetes who can truly engage with the nurse are more likely to become more interested in their diabetes self-care. An interactive relationship between nurse and patient may open communication and allow the adolescent to ask questions and take more responsibility for diabetes management. Critical social theory, as applied to the population of adolescents with diabetes, sheds light on the fact that many health care professionals oppress this group. With positive health outcomes as the goal of diabetes education and diabetes care, it seems only fitting that health care professionals, whose purpose is to promote health, would do whatever is necessary to facilitate that process. If adolescents with diabetes are made aware of their rights as consumers of health care and allowed to air their frustrations with diabetes care delivery, they can determine what works and what does not. The adolescents themselves deserve to decide what motivates them to take care of themselves and their diabetes. Nurses must first see the ways in which they are guilty of oppressing this population and then assist in opening the eyes of the adolescents themselves. When both groups understand where they have come from and where they need to go, they can work together to make the necessary changes. Open communication, understanding, and genuine concern will characterize positive health care professional–patient relationships in which adolescents with diabetes are able to learn about and eventually, if not immediately, take care of their diabetes. Positive relationships with health care professionals, a thorough knowledge of diabetes, and motivation and commitment to perform self-care activities are likely to result in happier adolescents and ultimately healthier adults with diabetes.
St. Paul University Dumaguete, Philippines
Time : 11:20-12:05
Richard D Pascua is a dedicated and committed Nurse Educator and Researcher who is passionate in improving nursing education towards development of nurses’ potential through continuous supportive process that stimulates and empower nurses to acquire the knowledge, skills and attitude, and be able to apply it with confidence, creativity and enjoyment. He is also a Lecturer on Advanced Adult Nursing, Nursing Administration, Psychiatric Nursing and Research both in tertiary and graduate school level.
This mixed-method research design utilized Copeland and Hewson’s (2000) questionnaire through a survey of all the clinical instructors and student-nurses in the fourth-level from the four universities in Negros Oriental, Philippines to evaluate the level of effectiveness of the teaching strategies employed in the clinical area. The evaluations made were compared across the different universities and whether the evaluations of the students relate to those of the instructors in general. It also employed separate Focus Group Discussions (FGDs) with six to eight instructors and student nurses, randomly chosen from those who have answered the questionnaire. These were analyzed through qualitative content analysis. Initially, open-coding was done to the transcribed FGD proceedings to map general categories and form themes and consequently, a framework was created to reveal the challenges they face in the clinical area. The study revealed that the clinical instructors rated their teaching strategies as excellently effective, while the students rated them as very effective. The study also revealed that the instructors are challenged by teacher-student generation, linguistic and cultural gaps and the students’ disturbed values system, undesirable scholastic traits and socio-economic state. Conversely, students are challenged by their instructors’ teaching and discipline styles. They are also confronted with institutional and personality prejudices in the clinical area. The study concluded that while the instructors and students view the effectiveness of the teaching strategies differently, they are also each other’s challenges. Thus, the study recommends enhanced teaching strategies through training.