BEST ORAL PAPERS NURSING
Saturday, 26 April 2008, 1145–1245hrs Auditorium, College of Medicine Building, Ministry of Health O-NUR (1145) Assessment of the Relationship Between HealthRelated Quality of Life SF36 & Oxford Knee Scores for Patients Who Had Total Knee Replacement: A 2-Year Follow Up Study Mr Nidu Maran Balakrishnan, Nursing, Singapore General Hospital O-NUR (1155) Caregiver Burden Assessment in an Elderly Cancer Patient Population Ms Chan Li Li, Medical Oncology, National Cancer Centre O-NUR (1205) An Exploratory Study on the Isolation Experience of Patients with Haematological Disorders Mr Hwang Chung Cheng, Nursing, Singapore General Hospital O-NUR (1215) A Prospective Study to Examine the Effectiveness of Flu Vaccination in Reducing Absenteeism Among Nursing Staff Ms Rubiyah Karlin, Nursing, Singapore General Hospital O-NUR (1225) The Effect of Clinical Teaching Nursing Rounds on Nurses’ and Patients’ Perception of Care Ms Lim Su-Fee, Nursing, Singapore General Hospital O-NUR (1235) Effectiveness of a Brief Smoking-Cessation Intervention Programme Among Hospitalized Patients at the National Heart Centre Ms Teo Lee Wah, Nursing, National Heart Centre
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Best Oral Papers (Nursing)
O-NUR (1145) ASSESSMENT OF THE RELATIOSHIP BETWEEN HEALTH-RELATED QUALITY OF LIFE SF36 & OXFORD KNEE SCORES FOR PATIENTS WHO HAD TOTAL KNEE REPLACEMENT: A 2-YEAR FOLLOW UP STUDY B Nidu MS1, Ahmad N1, Kaur S1, Yip SM1, Lo NN2, Yeo SJ2, Yang KK2, Chia SL2, Yeo W3, Chong WC3 1 Division of Nursing, Singapore General Hospital, Singapore 2 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 3 Orthopaedic Diagnostic Centre, Singapore General Hospital, Singapore Aim: The purpose of this study was to identify the relationship between QOL SF36 and Oxford Knees Scores for patients undergoing total knee replacement (TKR) surgery. Methods: Patients who had total knee replacement from January 2004 to December 2004 were recruited through prospective outcome databases from the institution’s orthopaedic diagnostic centre. Two health outcome measurement tools were used: Medical Outcomes Study Short Form (SF-36) and Oxford Knee Scores. We analysed these scores at one-week pre-op, 6 and 24 months post-operation. Results: 908 patients (Male n=164/Female n= 744) were recruited to the study.Seven hundred and twenty-two patients completed the 2-year follow up. SF36 and Oxford knee scores showed a progressive improvement in patients health from pre-op (r=35.28) (p<0.001) and from 6 months (r=21.2) (p<0.001) to 2 years (r=18.5) (p<0.001). The SF36 showed improvements in all but one area (General Health) for all patients at 6 months (r=77.217) (p<0001) and two years (r=71.121) (p<0.001). Conclusion: There was a linear relationship between the SF36 and Oxford knees scores in assessing the health outcomes after total knee replacement.
O-NUR (1155) CAREGIVER BURDEN ASSESSMENT IN AN ELDERLY CANCER PATIENT POPULATION Li Li Chan1, Donald Poon1, Rachel Towle2, Zi Zhen Xu3, Siew Bee Lian3, Wen Hsin Koo1 1 Geriatric Oncology Programme, Department of Medical Oncology, National Cancer Centre, Singapore 2 Department of Geriatric Medicine, Singapore General Hospital, Singapore 3 Ward 48 Nursing, Singapore General Hospital, Singapore Aim: The purpose of the study is to assess the level of burden of care in main caregivers of an Asian cohort of elderly cancer patients and identify the characteristics in patients and disease profile associated with the increased burden. Methods: The careburden interview designed by Zarit et al was administered to the main caregivers of a group of Asian elderly cancer patients referred to our geriatric oncology programme. The 22 questions interview was conducted by a single interviewer and the aggregate score categories of 0-20, 21-40, 41-60, 61-88 indicate little, mild, moderate and severe level of burden respectively. Results: The burden interview was conducted for 55 caregivers of a group of consecutive patients reviewed in our programme. Median age of the patients was 75 (range 70-82), 21 (37%) were female and 36 (63%) were male. Majority were ethnic Chinese (98%) and 51 (90%) lived together with their children. Majority of the caregivers 44 (77%) experienced mild level of burden while only 20% experienced moderate level of burden. In both the univariate and multivariate analyses, increased level of burden was significantly associated with the patient being dependent in Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL) with p=.026 and p=.009 respectively. No significant association was found with the scores of Geriatric Depression Scale or the Mini-Mental State Examination. Disease profile such as stage/type of cancer and comorbidity did not influence the level of burden in the caregiver in this analysis. Conclusion: The burden interview should be included in a Comprehensive Geriatric Assessment (CGA), particularly so if the elderly cancer patient is found to be dependent in ADL/IADL during screening assessment. The emotional health of the caregiver should be further evaluate and manage if there is moderate to severe level of burden/stress experienced by the caregiver.
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Best Oral Papers (Nursing)
O-NUR (1205) AN EXPLORATORY STUDY ON THE ISOLATION EXPERIENCE OF PATIENTS WITH HAEMATOLOGICAL DISORDERS Hwang CC1, Lee XQ2, Ho KT3 1 Ward 72, Department of Haematology, Singapore General Hospital, Singapore 2 Ward 54, Department of Haematology, Singapore General Hospital, Singapore 3 Ward 48, Department of Medical Oncology, Singapore General Hospital, Singapore Background: In spite of advances in medical treatment, isolation appears to be an inevitable part of the treatment process of patients with haematological disorders. The benefits of isolation have been well documented but previous studies on the isolation experiences of patients with haematological disorders produced contradicting results. Method: A qualitative study adopting a face to face semi-structured interview was conducted in a haematological unit of a local acute hospital. Patients who fulfilled the study’s inclusive criteria were recruited for the study. Data collection was on day 3 of the participants’ isolation. Guiding questions of the interview were developed from Roy’s Adaptation model and Maslow’s hierarchy of needs theory and served as the framework for data analysis. A pilot study was conducted prior to the commencement of the actual study to verify the validity of the questions. Manually transcribed interview manuscripts were analysed, clustered into themes, compared, consolidated and constructed to answer the research question. Demographic profiles collected were analysed using descriptive statistics of the SPSS software. Results: Four patients participated in the study and data saturation was achieved by the fourth interview. Five emergent themes were identified from the study. The themes were being isolated; previous isolation experience; coping with isolation; maintaining contact and the presence of loved ones. The support from the family, presence of a caregiver and visits made by loved ones were found to have significantly mediated the effects of isolation. In general, participants of the study found the isolation experience to be manageable but not enjoyable. It was also suggestive that nurses have a considerable role to play in the care of these patients. Conclusion: The findings suggest that preparing these patients early and providing them with vital information of isolation was found to be of importance in helping them adapt to isolation. O-NUR (1215) A PROSPECTIVE STUDY TO EXAMINE THE EFFECTIVENESS OF FLU VACCINATION IN REDUCING ABSENTEEISM AMONG NURSING STAFF R Karlin1, ML Ling1, YY Wong1, Y Yang2 1 Infection Control, Occupational Health, Singapore General Hospital, Singapore 2 Epidemiology Unit, Singapore General Hospital, Singapore Background: Staff in the Nursing Division of SGH has been known to have the highest influenza (flu) vaccination rate (from the occupational Health & Epidemiology Unit SGH). This study aims to determine the effectiveness of flu vaccination in reducing absenteeism amongst nursing staff. Method: A prospective study was conducted in Wards 45, 57, 63 and 76, from September 2006 to April 2007. We collected the nursing staff sick leave and hospitalisation leave record from their respective nurse managers and their immunisation status from Occupational Health & Epidemiology Unit of SGH. The demographic data of the participants were obtained by means of personal interview of the participants. Correlation was then done to see the relationship between flu vaccination and absenteeism due to URTI. Results: A total of 171 nursing staff participated in the study, of which 114 were vaccinated, 57 unvaccinated and 30 subjects were rejected. The rate of URTI/ flu like symptoms was higher among the vaccinated group (71.1%)) as compared to the unvaccinated subjects (61.4%). The results showed no statistical differences in the vaccinated and unvaccinated nursing staff who had sick/hospitalisation leaves due to URTI/ flu like symptoms (Mann-Whitney test, p=0.221). In the vaccinated group the mean was 1.5 days absence from work versus 1.2 days for the unvaccinated group. The total episode of sickness also did not show significant difference - the mean was 1.1 in the vaccinated group versus 0.9 episode for unvaccinated group (Mann-Whitney, p=0.195). Conclusion: The 7-month prospective study has shown that no significant impact of the flu vaccination on the rate of absenteeism due to URTI. This could be due to the fact that the URTI could be due to other viruses.
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O-NUR (1225) THE EFFECT OF CLINICAL TEACHING NURSING ROUNDS ON NURSES’ AND PATIENTS’ PERCEPTION OF CARE Lim SF, Tan SB, Lian SB, Kaur K Nursing Division, Singapore General Hospital, Singapore Aim: A project was initiated to improve patient education and staff development through clinical teaching nursing rounds undertaken by the Nurse Clinicians Specialty Care working in SGH in 2006. The aim of this study was to explore the effect of clinical teaching nursing rounds on nurses’ and patients’ perception of care. Methods: Descriptive cross-sectional survey using multiple choice questionnaire and short answer was used for patients after each clinical teaching nursing rounds from October 2006 to March 2007. The survey for nurses was done in 2 phases (November 06, March 07). Data was analysed using SPSS Window Version 13.0. Descriptive statistics were generated for each question. Chi-square test or Fisher’s exact test was used where appropriate to study the association between each question and clinical teaching. Statistical significance was assumed at p < 0.05. Results: Twenty patients and 129 nurses (phase 2) completed the study. All patients and specialty care nurses favoured clinical teaching. Ward nurses who participated in the clinical teaching were more favourable to clinical teaching as compared to the nurses who did not participate (p=0.02). Better understandings of medical and nursing problems rank the highest as the reason for in favour of clinical teaching for patients. The specialty care nurses and ward nurses perceived clinical teaching as most beneficial in terms of gaining more knowledge from fellow nurses and specialty care nurses. Conclusion: Clinical teaching nursing rounds enhances bedside patient education and provides nurses the opportunity to gain nursing knowledge through on-site continuous learning.
O-NUR (1235) EFFECTIVENESS OF A BRIEF SMOKING-CESSATION INTERVENTION PROGRAMME AMONG HOSPITALISED PATIENTS AT THE NATIONAL HEART CENTRE Teo LW1, Yap TT1, Ting P2, Chan K PW3 1 Nursing Development Unit, National Heart Centre, Singapore 2 Department of Cardiology, National Heart Centre, Singapore 3 Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore Aims: Smoking is a major cause of cardiovascular disease, chronic obstructive lung disease and lung cancer, making it the most preventable cause of death in the world. Hospitalisation represents an opportune situation whereby patients may be more receptive to smoking cessation interventions. This study aims to determine the effectiveness of an inpatient smoking cessation programme initiated in hospitalised patients admitted to Cardiology and Cardiothoracic Surgical Units at the National Heart Centre, Singapore. Methods: The smoking cessation intervention programme was delivered by nurses and certified smoking cessation counsellors. The intervention begins when patients were admitted to the hospital. All identified smokers were given brief smoking cessation advice and written materials. Patients who were ready to quit, were referred to nurses who had been trained and certified as smoking cessation counsellors. The primary outcome was the continuous abstinence rate at 6 months. Results: Over a 1-year period from September 2006 to August 2007, there were 3,938 admissions, of which 615 (15.6%) were current smokers. Five hundred and ninety-four (96.6%) patients who were current smokers, received brief counselling and written materials. A further 170 (27.6%) patients consented to further counselling by a smoking cessation counsellor. The 6-month continuous abstinence was 42.4%. Of the patients who quit, 90% had only one encounter with a smoking cessation counsellor and 86% of them did not utilise any pharmacotherapy for smoking cessation. Conclusion: Despite a relatively brief intervention, long-term quit smoking rates are achievable. More resources are needed to address the large proportion of hospitalised patients who are not willing to quit.
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