Post-test Intervention Study Research Articles

Impact of a psychoeducational intervention on willingness to seek help for depression among African American young adults.

Despite the success of psychoeducational interventions at improving willingness to seek professional help for mental illness, limited research explores the effect of culturally tailored psychoeducational interventions on African American (AA) college students. The objective of this study was to determine if exposure to a culturally relevant psychoeducational intervention impacted AA young adult attitudes, subjective norms, perceived behavioral control, depression stigma, disclosure and willingness to seek help for depression. We conducted a one-group pre- and post-test intervention study of AA college students (N = 75). The 2.5-h intervention featured presentations, large-group discussions, videos, and active learning exercises and was guided by applying a cultural adaptation framework to an existing psychoeducational intervention. The self-administered surveys were created using the Theory of Planned Behavior as a guide. Data were analyzed using paired t-tests. A total of 70 participants completed both pre- and post-test surveys. Overall, willingness, attitude, and disclosure significantly increased after the intervention (p < .001). Additionally, depression stigma significantly decreased after the intervention, indicating fewer stigmatizing beliefs about depression (p < .001). Willingness to seek help for depression among AA college students can be improved through culturally relevant and interactive psychoeducational interventions. These interventions can also improve negative attitudes and perceived behavioral control toward seeking help and decrease stigmatizing beliefs. More research is needed to explore the longitudinal impact of culturally relevant psychoeducational interventions and how they may affect actual help-seeking behavior among AA college students.

IMPACT OF PSYCHODRAMA ON EMOTIONAL AWARENESS AND PSYCHOLOGICAL WELL-BEING IN UNIVERSITY STUDENTS

Objective: The aim of this study is to determine the effect of psychodrama on emotional awareness and psychological well- being of university students. &#x0D; Material and Methods: The study was a pretest, posttest intervention study with a control group. The study group included a total of 38 university students, 18 experimental students and 20 control group students. The researchers performed an eleven-session psychodrama group activity on the experimental group. However, they did not intervene in the control group. The researchers collected the data by distributing data collection tools (Information Form, the Emotional Self- Awareness Scale and the Psychological Well Being Scale) to the students before and after the psychodrama study. &#x0D; Results: The study found that the psychodrama group activity had a great impact on the psychological well being and emotional self-awareness level of the experimental group students (p

Music as an Adjuvant Therapy in Postoperative Pain and Physiologic Parameters: Pre-Test, Post-Test Intervention Study

BackgroundPoorly controlled postoperative pain remains a significant challenge. Music is a safe, inexpensive, non-invasive intervention that can be used in managing pain in surgical patients.ObjectivesTo evaluate effectiveness of music intervention as an adjuvant therapy in attenuating postoperative pain among patients with tibia/fibula fractures.MethodologyA cross-sectional pre-test, post-test intervention study design was utilized to conduct a study involving 20 tibia-fibula patients, divided equally into intervention and control groups. Self-selected music was administered for 20 minutes to the intervention group once on day-3 after surgery. Data was collected using a demographic questionnaire and Visual Analogue Scale (VAS).Data was analyzed using SPSS software version 29.0. Descriptive statistics analyzed continuous and categorical data. T-test compared means of physiologic parameters and pain levels in pre-and post-intervention. ANCOVA established the relationship between music and post-intervention pain levels.FindingsUse of music alongside conventional therapy significantly reduced pain in the intervention group than in the control group (P = 0.014). Music had no statistically significant impact on the physiological parameters.ConclusionMusic therapy is effective as an adjuvant therapy for pain management and can therefore reduce the use of analgesics among surgical patients.Rwanda J Med Health Sci 2023;6(3):290-302

Effects of a phonics intervention in a randomized controlled study in Swedish second-grade students at risk of reading difficulties.

Teaching phoneme awareness to children at risk for early reading difficulties has been recognized as successful in several studies. In this randomized controlled trial (RCT)-study, we add to this research by optimizing core procedural as well as teaching components in a phonics-directed intervention and extend the RCT reading intervention research into a semi-transparent language context. The aim of the present study was to evaluate the effects of a novel Swedish intensive phonics program. This randomized controlled pre-test and post-test intervention study targeted second-grade students with early reading difficulties. Students were identified by a repeated screening procedure and allocated to intervention (n = 34) and control (n = 34) conditions. A 9-week intensive phonics-based program was administrated one-to-one, by special education teachers in Swedish mainstream elementary schools. Results show an improvement in the intervention group, compared with the controls on all outcome measures. Findings indicate that the supplementary phonics program, delivered with high intensity, can significantly increase word reading skills and reading comprehension in second-grade students with early reading difficulties.

The impact of a cognitive impairment support program on patients in an acute care setting: a pre-test post-test intervention study

BackgroundPatients with cognitive impairment are at greater risk of hospital acquired complications, longer hospital stays, and poor health outcomes compared to patients without cognitive impairment. The Cognitive Impairment Support Program is a multi-disciplinary approach to improve screening rates and awareness of patients with cognitive impairment and guide clinician response and communication during their hospitalisation to improve health outcomes.ObjectiveThis study evaluated the impact of implementing the Cognitive Impairment Support Program on patient hospital acquired complications, patient reported quality of life and staff satisfaction in an outer metropolitan hospital.DesignA pre-test post-test design was used to collect data in two 6-month time periods between March 2020 and November 2021.ParticipantsPatients aged ≥ 65 years, admitted to a participating ward for > 24 h.InterventionThe Cognitive Impairment Support Program consisted of four components: cognitive impairment screening, initiation of a Cognitive Impairment Care Plan, use of a Cognitive Impairment Identifier and associated staff education.MeasuresThe primary outcome was hospital acquired complications experienced by patients with cognitive impairment identified using clinical coding data. Secondary outcomes were patient quality of life and a staff confidence and perceived organisational support to care for patients with cognitive impairment.ResultsHospital acquired complication rates did not vary significantly between the two data collection periods for patients experiencing cognitive impairment with a 0.2% (95% confidence interval: -5.7–6.1%) reduction in admissions with at least one hospital acquired complication. Patients in the post intervention period demonstrated statistically significant improvements in many items in two of the Dementia Quality of Life Measure domains: memory and everyday life. The staff survey indicated statistically significant improvement in clinical staff confidence to care for patients with cognitive impairment (p = 0.003), satisfaction with organisational support for patients (p = 0.004) and job satisfaction (p ≤ 0.001).ConclusionThis study provides evidence that a multicomponent Cognitive Impairment Support Program had a positive impact on staff confidence and satisfaction and patient quality of life. Broader implementation with further evaluation of the multicomponent cognitive impairment intervention across a range of settings using varied patient outcomes is recommended.

Perceptions of interprofessional collaboration at the intersection of child welfare and child and adolescent psychiatry in Germany

In Germany (and other countries) a significant proportion of children and young people in contact with the child welfare system do not receive adequate mental health care. Fragmented service delivery has been partially attributed to a lack of interprofessional collaboration between the child welfare system and providers of child mental health services. Child and adolescent psychiatric (CAP) clinics provide the majority of child mental health care for the child welfare population in Germany. In this paper, we present the first wave of data collected in a nonrandomized pretest–posttest intervention study, in which we examined the collaboration between child welfare services and CAP clinics in Northern Germany with a sample of N = 204 professionals in total, from both organizations. We used two standardized measurements. The general quality of collaboration was measured using an established tool, the “Perceptions of Interprofessional Collaboration Model – Questionnaire” (PINCOM-Q). Perceptions of collaboration around children with complex care needs were measured with a newly developed scale, the “Perceptions of Interprofessional Collaboration Scale for Children with Multiple and Complex Needs” (PICOCC). The results show that perceptions of interprofessional collaboration differed based on organizational and professional affiliation. Frontline workers employed in the child welfare system compared to those working in CAP clinics had a more negative perception of collaboration in general, and felt their organization provided less support for collaboration. Social workers in both CAP and child welfare services perceived less organizational support for collaboration compared to mental health professionals. In the overall group of social workers, those working in the child welfare system felt their organization supported collaboration the least. Mental health professionals working in CAP clinics, however, had a more negative perception of collaboration around children with complex needs. This suggests that attention should be paid to perceptions of interprofessional collaboration as an important process variable, which may impact on frontline workers’ responsiveness to organizational change.

Implementation of the thirst management model in the burn unit guided by knowledge translation.

To implement the preoperative Thirst Management Model, measuring its adoption, coverage, acceptability, feasibility and fidelity by nursing in a burn unit. Quasi-experimental, pre- and post-test intervention study. Sample of 59 patients at pre-implementation and 40 post-implementation and 36 nursing professionals participating in the implementation in a burn unit from August (2019) to March (2020). Statistical analysis used Mann-Whitney and Chi-square. Adoption of management ranged from 0.0% to 72.5% post-implementation. The capacity coverage was 87.5% of nurses and 87.9% of nursing technicians. There was acceptability and feasibility of thirst management by professionals. In the plan-do-study-act cycles, three pillars of the Model reached the goals, showing fidelity. The implantation of the Preoperative Thirst Management Model had acceptability and feasibility by the nursing team, showing fidelity in achieving the proposed goals, in addition to the adoption of evidence in clinical practice after high coverage professional training.

Prescribing tailored home exercise program to older adults in the community using a tailored self-modeled video: A pre-post study.

Community rehabilitation for older people after hospital discharge is necessary to regain functional ability and independence. However, poor adherence to exercise programs continues to hinder achieving positive health outcomes in older people. This study aimed to evaluate the effectiveness of prescribing a tailored video self-modeled DVD-HEP for 6 weeks, on functional mobility, physical activity, exercise self-efficacy, and health-related quality of life, in a sample of frail older adults. A pre- and post-test intervention study design was conducted, with each participant acting as their own control. A convergent, parallel, mixed-methods approach involving quantitative, and qualitative data collection was used. Participants received an individualized assessment at baseline and subsequently were provided with a 30-min tailored 6-week self-modeled DVD-HEP that showed the physiotherapist instructing the participant. The physiotherapist phoned participants fortnightly to encourage engagement in the program and explore responses to it. Outcomes evaluated included functional mobility, balance, gait speed, and exercise self-efficacy. Participants (n = 15) showed clinically meaningful improvements at follow-up compared to baseline in functional mobility (TUGMCID = 3.4-3.5 s, 3-MWTMCID = 0.1-0.2 m/s) and gait speed (3-MWTMCID = 0.1-0.2 m/s). There were also significant improvements in balance and self-efficacy for exercise and a 2.5- and a 1.3-fold increase in moderate and light physical activity participation at follow-up compared to baseline. The deductive themes were: (i) Enjoyment, self-efficacy, and wellbeing; (ii) Achieving life goals; (iii) Background music as a motivator to adherence; and (iv) Enhanced motor performance and learning: Task goal mastery, multimodal feedback, autonomy to self-regulate learning. The new inductive theme was (v) Preference for in-person support for exercise. Future studies are warranted to compare a tailored self-modeled video HEP to face-to-face programs and other digital health modalities to evaluate older adults' adherence levels and functional improvement.

Drill; A Solution to Reduce Mistriage in Prehospital Emergency Setting

Background: Triage is used as one of the main concepts in the emergency medicine to differentiate between critically ill patients or patients in a non-emergency situation. Miss-triage occurs if the prioritization of patients or injured is not done correctly for any reason. Miss-triage occurs in two forms of over and under triage. According to studies, the incidence of miss-triage is high worldwide. Exercising is one of the ways to reduce the amount of miss-triage. Objectives:. This two-group pretest post-test intervention study aimed to investigate the effect of drilling on the miss-triage of emergency medical service personnel. Methods: The tools used in this study included: demographic information form questionnaire, Triage Decision Making Inventory (TDMI), and designed START/jump START triage scenarios. After collecting the required data, these data were analyzed by appropriate parametric and non-parametric statistical tests, including mean and standard deviation, independent t-test, paired t-test, K-square. Results: Results showed that the Miss-triage rate decreased from (34.1%) before the intervention to (9.1%) after the intervention in the experimental group. Moreover, after drill, the score of triage decision-making power increased from (121) to (136.91). However, in the control group, no statistically significant change was observed in the amount of miss-triage and triage decision-making power in emergency medical service personnel at the end of the study (p&gt;.05). Conclusion: The findings of the present study revealed the effectiveness of this exercise method in reducing miss-triage in participants. Thus, this method could be used in emergency medical service personnel training and preparation programs.

Pressure ulcers in patients with COVID-19 acute respiratory distress syndrome undergoing prone positioning in the intensive care unit: A pre- and post-intervention study.

Prone positioning has been widely used to improve oxygenation and reduce ventilator-induced lung injury in patients with severe COVID-19 acute respiratory distress syndrome (ARDS). One major complication associated with prone positioning is the development of pressure ulcers (PUs). This study aimed to determine the impact of a prevention care bundle on the incidence of PUs in patients with COVID-19 ARDS undergoing prone positioning in the intensive care unit. This was a single-centre pre and post-test intervention study which adheres to the Standards for Reporting Implementation Studies (StaRI) guidelines. The intervention included a care bundle addressing the following: increasing frequency of head turns, use of an open gel head ring, application of prophylactic dressings to bony prominences, use of a pressure redistribution air mattress, education of staff in the early identification of evolving PUs through regular and rigorous skin inspection and engaging in bedside training sessions with nursing and medical staff. The primary outcome of interest was the incidence of PU development. The secondary outcomes of interest were severity of PU development and the anatomical location of the PUs. In the pre-intervention study, 20 patients were included and 80% (n= 16) of these patients developed PUs, comprising 34 ulcers in total. In the post-intervention study, a further 20 patients were included and 60% (n= 12) of these patients developed PUs, comprising 32 ulcers in total. This marks a 25% reduction in the number of patients developing a PU, and a 6% decrease in the total number of PUs observed. Grade II PUs were the most prevalent in both study groups (65%, n= 22; 88%, n= 28, respectively). In the post-intervention study, there was a reduction in the incidence of grade III and deep tissue injuries (pre-intervention 6%, n= 2 grade III, 6% n= 2 deep tissue injuries; post-intervention no grade III ulcers, grade IV ulcers, or deep tissues injuries were recorded). However, there was an increase in the number of unstageable PUs in the post-intervention group with 6% (n= 2) of PUs being classified as unstageable, meanwhile there were no unstageable PUs in the pre-intervention group. This is an important finding to consider as unstageable PUs can indicate deep tissue damage and therefore need to be considered alongside PUs of a more severe grade (grade III, grade IV, and deep tissue injuries). The use of a new evidence-based care bundle for the prevention of PUs in the management of patients in the prone position has the potential to reduce the incidence of PU development. Although improvements were observed following alterations to standard practice, further research is needed to validate these findings. The use of a new, evidence-based care bundle in the management of patients in the prone position has the potential to reduce the incidence of PUs.

Anesthcalc™ is Associated with Superior Accuracy and Faster Accomplishment in Simulation-based Anesthesia Drugs Dosage Calculation

Abstract Background: Medication error is one of the barriers to achieving sustainable patient safety. We aim to determine the efficacy and reliability of a smartphone dosage calculator application (AnesthCalc™) when compared with the manual calculation of various anesthetic drugs to prevent medication error. Materials and Methods: This is a pre-test–post-test intervention study. There are 52 participants who included residents in anesthesiology, which is divided into two groups. Each group performed two simulation cases in which they had to calculate drugs dosage in anesthesia settings. One set of cases was performed with the app and the other set was performed manually. The order of drugs and simulation patients was randomized. The accuracy and the deviation of administered drug doses were recorded. Accuracy of dosage was categorized as either accurate (80–100% of target dose) or inaccurate (less than 80%), whereas the deviation of dosage was categorized as either deviant (&lt;50% or &gt;200% of target dose) or safe (between the range). Results: There is a significant increase in the accuracy of calculation between the manual group and that using the app group (from 46% to 92%, a mean increase of 18.29%, P &lt; 0.005). There is a significant decrease in the duration of calculation between without using the app group and with using the app group (from 32.92 to 18.79 s, a mean decrease of 30.55 s, P = 0.001). Conclusion: AnesthCalc™ is a valid and reliable instrument as it increases users’ accuracy and shortens calculating time. AnesthCalc™ may be the potential to reduce calculation errors and may increase patients’ safety.

Cardio-pulmonary-resuscitation for people who use a wheelchair and/or have an atypical chest shape: an educational intervention

Purpose To determine the impact of the addition of information specific to people with atypical chest shapes and/or in a wheelchair during mandatory CPR classes on staff confidence to respond to emergency scenarios with these populations. Materials and methods A pre-test post-test intervention study was conducted with staff from one of the largest disability organisations in Tasmania, Australia. Supplemented CPR and BLS classes were presented to participants. A purpose-designed questionnaire was completed pre, post, and six-months post after the training. Results A significant rise in confidence post-training was demonstrated, and this was retained at the six-month time point. Time spent in the disability sector before the supplemented training or attendance at previous standard CPR classes did not have a significant effect on confidence levels before the supplemented training. Conclusions Confidence is closely linked to willingness to act during emergency situations. Improved confidence may therefore result in improved willingness to act for people with disability, atypical chest shapes, and wheelchair users, thus improving health outcomes for these populations and providing this cohort with access to more equitable healthcare. IMPLICATIONS FOR REHABILITATION Guidelines for undertaking CPR and BLS on people with atypical chest shapes and/or in a wheelchair are not currently available. Including information specific to people with atypical chest shapes and/or in a wheelchair during mandatory CPR classes increases staff confidence to respond to such situations. Supplementary disability-specific information can be successfully incorporated into existing CPR and BLS training.

Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments

IntroductionEmergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury. AimThis study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries. MethodsThe study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the “Emergency Department Patients Information and Pressure Injury Assessment Form” and “The Braden Scale for Predicting Pressure Injury Risk”. In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using “The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)” and “The Questionnaire for Identifying and Preventing Pressure Injury”. In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher’s Exact Chi-square test were also used. ResultsThe mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards. ConclusionIt was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.

Impact of health education on preventive measures of Rabies among primary school teachers in Mandalay, Myanmar

Background: Rabies is an exceptionally fatal zoonotic disease and major public health problem in developing countries. Health knowledge of preventive measures of rabies among primary school teachers is paramount to cultivate their students and create a secure and safe environment since primary school students are the most vulnerable group. The study aimed to assess the effect of health education on knowledge of preventive measures of rabies among primary school teachers.Methods: A pre and post-test intervention study was conducted among randomly selected 64 primary school teachers from 7 Townships in Mandalay from July to October, 2020. An educational intervention was conducted by contributing 4 sheets of pamphlets and appearing 5 minutes education video record and reassessment was done one month later.Results: The mean knowledge scores before and after intervention were 40.59±4.85 and 47.75±4.02 showing statistically significant improvement (p&lt;0.001). Mean of the improvement percentage was 19.38±5.06. Out of 64 participants, 37.5% had good knowledge in pre-test which improved to 95.3% in post-test (p&lt;0.05). Although, age, marital status, having children and having stray dogs near school compound were adjusted in multiple linear regression, there was no statistical significance association with improvement percentage.Conclusions: There is improvement of knowledge status, which is not influenced by sociodemographic factors, following educational intervention. This highlights the need of continuing medical education for preventive measures of rabies for both primary school teachers and primary school students.

Using field training in indigenous communities as a method of creating awareness of the one health concept among Malaysian university students: a non-experimental pre and post-test intervention study

BackgroundThis paper describes the result of workshops conducted to increase the knowledge and awareness of university students using a multidisciplinary, collaborative, multisectoral and trans-disciplinary approach concerning One Health and the indigenous people of peninsular Malaysia called the Orang Asli.MethodsA non-experimental pre and post-test intervention study was carried out among medical, veterinary and allied health students from six public and private universities who attended workshops on One Heath in two Orang Asli communities living by the Temenggor lake in Malaysia as part of the Malaysia One Health University Network (MYOHUN) efforts in training future and present One Health workforce.ResultsThere was a significant increase in various aspects of knowledge and interest concerning One Health and the Orang Asli. The mean knowledge scores of One Health (p < 0.001) and Orang Asli (p < 0.001) increased significantly post workshop. A repeated measures ANOVA with a Greenhouse-Geisser correction showed the mean scores of knowledge of One Health F (1, 166) = 127.198, p < 0.001) and Orang Asli F (1, 166) = 214.757, p < 0.001) differed statistically significantly between the two time points. The test revealed that the score differences for knowledge on One Health (mean difference = 1.796, p < 0.001) and Orang Asli (mean difference = 4.940, p < 0.001) were statistically significant. Repeated measures ANOVA showed a significant difference in the knowledge on Orang Asli between the students of different courses F (4,166) = 3.734, p-0.006. The difference in the One Health knowledge scores between the students of different courses was not statistically significant F (4,166) = 0.998, p = 0.410.ConclusionsEmphasis on field training in relation to One health can provide university students greater levels of preparedness to combat zoonotic diseases.

Impact of ‘HIV-related stigma-reduction workshops’ on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study

IntroductionPeople living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result...

Outcome of Carer-Assisted Care for Stroke Survivors with Severe Disability: Preliminary Findings

Involvement of informal carer in post-stroke care is important to prevent development of secondary complications particularly among stroke survivors with severe disability. However, to date, evidence on the benefit of stroke care training and involving carer to assist in the care for this group of stroke survivors is still limited. In this study, we evaluated the outcome of a carer-assisted care program for stroke survivors with severe disability who live at home. Sixteen stroke survivors with severe disability and 16 primary carers participated in this pre-test post-test intervention study. Carers were trained using a stroke care module which was developed by a group of multidisciplinary researchers from Universiti Kebangsaan Malaysia, prior to implementing the daily care for 8 weeks. Outcome of care on stroke survivors was assessed in term of change in disability level and quality of life using Modified Barthel Index (MBI) and EuroQol health-state measure (EQ-5D and EQ-VAS), respectively. While outcome of stroke care training on carer was determined using Modified Caregiver Strain Index (MCSI). Significant improvement is shown in the stroke survivors’ EQ-VAS component of EuroQol health state measure (average increase by 12%, t = 2.86, p = 0.01) following the care. Although not statistically significant (t = 0.97; p = 0.35), the mean score of MCSI reduced by 14%. No significant change was found in the MBI of the stroke survivors at completion of the program. Carer-assisted care is useful in improving quality of life of stroke survivors and can potentially reduce stress level among carers. Larger study may assist in establishing these preliminary findings. DOI : http://dx.doi.org/10.17576/JSKM-2019-17SI-08

Outcome of Carer-Assisted Care for Stroke Survivors with Severe Disability: Preliminary Findings

Involvement of informal carer in post-stroke care is important to prevent development of secondary complications particularly among stroke survivors with severe disability. However, to date, evidence on the benefit of stroke care training and involving carer to assist in the care for this group of stroke survivors is still limited. In this study, we evaluated the outcome of a carer-assisted care program for stroke survivors with severe disability who live at home. Sixteen stroke survivors with severe disability and 16 primary carers participated in this pre-test post-test intervention study. Carers were trained using a stroke care module which was developed by a group of multidisciplinary researchers from Universiti Kebangsaan Malaysia, prior to implementing the daily care for 8 weeks. Outcome of care on stroke survivors was assessed in term of change in disability level and quality of life using Modified Barthel Index (MBI) and EuroQol health-state measure (EQ-5D and EQ-VAS), respectively. While outcome of stroke care training on carer was determined using Modified Caregiver Strain Index (MCSI). Significant improvement is shown in the stroke survivors’ EQ-VAS component of EuroQol health state measure (average increase by 12%, t = 2.86, p = 0.01) following the care. Although not statistically significant (t = 0.97; p = 0.35), the mean score of MCSI reduced by 14%. No significant change was found in the MBI of the stroke survivors at completion of the program. Carer-assisted care is useful in improving quality of life of stroke survivors and can potentially reduce stress level among carers. Larger study may assist in establishing these preliminary findings.

Investigation of wet cupping therapy’s effect on oxidative stress based on biochemical parameters

IntroductionWet cupping therapy is one of the main applications which has been used in the Unani medicine system. Current literature explaining how this traditional treatment method works is still limited. The aim of this study was to investigate whether wet cupping therapy could affect reactive oxygen species and antioxidant levels. MethodsThis was a single arm pre and posttest intervention study conducted in Karabuk University Teaching and Research Hospital (KUTRH) between 1st January and 1st May 2018. Twenty-four participants were included. Wet Cupping Therapy was applied to all individuals once every month for three months. Venous blood samples were collected before the first (Venous1) and after the last application (Venous 2) and cupping blood samples were collected during the first and last applications. Malondialdehyde (MAD) and total oxidant status (TOS) which both indicate oxidation; glutathione (GSH), superoxide dismutase (SOD), total antioxidant status (TAS), catalase (CAT) activities that indicate antioxidant effect, and protein levels were measured on the obtained serums. ResultsThe highest MDA and TOS levels and the lowest TAS, GSH, SOD and CAT levels were found in initial cupping blood. Significant improvement was observed in second cupping blood for these parameters when compared to initial values. We also found that MDA and TOS levels, as well as TAS, GSH, SOD and CAT levels, all changed favorably in the Venous 2 blood sample compared to the Venous 1 (p < 0.001). ConclusionWet cupping therapy seems a promising method for increasing antioxidant levels and curbing oxidative stress.

AUDIT SYSTEM FOR USAGE OF BLOOD PRODUCT IN SANGLAH GENERAL HOSPITAL DENPASAR BALI

Blood transfusion is one of very important therapy components. One indicator of the blood services quality in Sanglah General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ≤ 10% per month. However, these targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders is mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%), Department of Obstetrics and Gynecology (15.5%) , and Department of Pediatrics (8%). The high number of unused blood orders can causes several problems such as the disorder of blood supply, inefficiency of pre-transfusion testing and decreased quality of blood product. Considering the consequences of high unused blood order, it is necessary to conduct a research on audit system for usage of blood product in Sanglah Hospital.The aim of study are to analyze the influence of audit system to reduce unused blood order and to decrease the number of C/T ratio. The study design was a pre and post test intervention study. The population in this study were all forming of blood requests in Sanglah Hospital. The sample is blood request form Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for usage of blood products, followed by concurrent audit and prospective audit of the sample.The study show there are decline of unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in Sanglah Hospital is 5.4%, and in the Department of Internal Medicine is 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because waiting for the schedule of hemodialysis, the patient has a fever, blood product has expired, and the occurrence of administration errors. Reduction of C/T ratio in Sanglah Hospital is 0,094 and in the Department of Internal Medicine is 0,072. Audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio.