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   Table of Contents - Current issue
Coverpage
January 2019
Volume 16 | Issue 1
Page Nos. 1-54

Online since Tuesday, October 15, 2019

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EDITORIAL  

Greetings from ISPN India p. 1
Sandhya Gupta
DOI:10.4103/IOPN.IOPN_17_19  
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ORIGINAL ARTICLES Top

A study to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia attending outpatient department of Lokopriyo Gopinath Bordoloi Regional Institute of Mental Health, Tezpur p. 2
Rinki Ghosh, Nurnahar Ahmed
DOI:10.4103/IOPN.IOPN_5_19  
Background: Mental illness is a condition that impacts a person's thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Among various types of mental illnesses schizophrenia is common disorder affecting approximately 1% of any given adult population. Stigma surrounding schizophrenia restraints the patient and family members to access the treatment facilities and type of support they need to manage their illness. It can also disturb the family environment which can often give rise to expressed emotion. Expressed emotion refers to a global index of particular emotions, attitudes and behaviours expressed by relatives of a family member diagnosed with schizophrenia. Aims and Objectives: The aim of the study was to assess the relationship between stigma and expressed emotion among the primary care givers of persons with schizophrenia. Materials and Methods: Descriptive co relational research design was used. The sample comprised of 60 primary caregivers of persons with schizophrenia attending OPD of LGBRIMH, Tezpur which was selected by using purposive sampling technique. Two standardized tool (Stigma subscale of Family Interview Schedule and Family Attitude Scale) and socio demographic data sheet was used for patient and primary care giver. Results: Finding showed majority of the sample i.e. 65% (n = 39) obtained the stigma score below 10.83 (mean score) and only 35% (n = 21) obtained the stigma score above10.83 (mean score).This finding showed that majority of the primary care givers has low stigma having a patient with psychiatric illness in their family. It was also showed that majority of the sample i.e. 66.7% have obtained expressed emotion score below 29.68 (mean score) and 33.3% have obtained expressed emotion score above 29.68 (mean score).This finding showed that the majority of the primary care givers has low expressed emotion towards a family member having schizophrenia. There was significant positive correlation found between stigma and expressed emotion among the primary care givers of persons with schizophrenia (calculated value was found to be 0.587 which was higher than the tabulated value at 0.01 level of significance). Conclusion: It showed that if stigma increases, the expressed emotion among the primary care givers towards the patient also increases.
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A cross-sectional study to assess the problematic use of mobile phones among a selected population in an urban area p. 7
Radhika Das, Punita A Sharma
DOI:10.4103/IOPN.IOPN_6_19  
Background: Life without a mobile phone would seem next to impossible today, where it is used not only for the sole purpose of communication but also as a storehouse of important personal information, internet facilities, navigation, social networking, bank transactions, and many more such needs. The use of mobile phones has also found to be a leading cause of road traffic accidents. This study assesses the mean score of mobile phone use among the selected population using Problematic Use of Mobile Phone (PUMP) questionnaire. Objective: The main objective of the study was to assess the PUMP usage among the selected population in an urban area. Materials and Methods: Quantitative nonexperimental descriptive design was followed.A total of hundred participants were included in the study and assessed using PUMP questionnaire, on the criterias of substance use disorder namely- Tolerance, Withdrawal, Craving, Social or interpersonal and Physical and psychological problems. Results: The mean scoring on PUMPs was 53%. Scores of most of the symptoms of substance abuse were more than 50% except those of withdrawal, use in physically hazardous situations, and use despite social or interpersonal problems. Conclusion: The selected population shows significantly high scores on PUMPs. Furthermore, most of the symptoms of substance abuse in the PUMP questionnaire have a scoring of over 50%.
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A descriptive study to assess the level of anxiety and depression among alcohol use disorder patient in a tertiary care hospital of Western Maharashtra p. 11
Seema Madhavan Nair, Punita A Sharma, Radhika Das
DOI:10.4103/IOPN.IOPN_7_19  
Background: Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. In addition to the direct pharmacological effects of alcohol on brain function, psychosocial stressors that commonly occur in heavy-drinking alcoholic patients (e.g., legal, financial, or interpersonal problems) may indirectly contribute to on-going alcohol-related symptoms, such as sadness, despair, and anxiety; the association of alcohol consumption and associated anxiety or depression need to be studied. The objectives of the study were to assess the (1) level of anxiety among the AUD patients and (2) level of depression among the AUD patients. Methodology: A descriptive study to assess the level of anxiety and depression among AUD patients in a tertiary care hospital of Western Maharashtra was conducted on 30 AUD patients from April 03 2018, to April 17, 2018. The Hospital Anxiety Depression Scale (HADS) containing 14 questionnaires, 7 for anxiety and 7 for depression, was administered; the collected data were analyzed and interpreted. Results: The analysis of the score has shown that 60% of the patients had mild anxiety and 40% possessed normal anxiety level in the anxiety component of HADS and 70% of the patients had mild depression and 30% of the patients had moderate depression in the depression component of the HADS. Those patients who have mild anxiety also have a mild or moderate level of depression. Conclusion: Assessment of associated anxiety and depression among AUD patients and subjecting to treatment if required will benefit the treatment compliance of AUD.
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A study to assess the causes, sources, and effects of selected psychoactive substance use among a selected rehabilitation center in Hyderabad with a view to develop an informational booklet p. 15
Anumol Joseph, Amreen Rupani, Anju Chacko, Clifty Prinson, Mythili Joanna, Sujana
DOI:10.4103/IOPN.IOPN_8_19  
Background: Psychoactive substance abuse, also known as drug abuse, is a patterned use of drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others and is a form of substance-related disorder. Objectives: The aim of the study was to assess the causes, sources, and effects of psychoactive substance use. Methodology: The present study is done by nonexperimental descriptive method, and the sampling technique used was purposive sampling technique. The study was conducted on a group of 60 inmates in Asha Jyothi Rehabilitation Center using a structured questionnaire.In regards to the effects of substance abuse reveal that majority (58.3%) of the clients were moderately affected and the remaining (41.6%) were severely affected.There were no addicts with mild effects. With regard to causes, 30 (60%) samples took substances to feel energetic and 24 (40%) of them take to feel high on taking just once. Major cause of psychoactive substance use identified was peer pressure found in 28 (46.3%) inmates. Regarding the sources of procurement, the majority, i.e., 36 (60%), of subjects consumed alcohol. The main source of procurement was friends (35, 58.3%) and the preferred place was in friend's home (27, 45%) with friends (44, 73.3%). The study can be useful in educating youth and addicts about substance abuse and its prevention.
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Evaluative study to assess the level of anxiety among the patients undergoing endoscopy at All India Institute of Medical Sciences, Hospital Bhubaneswar p. 19
Nanda Kumar Paniyadi, Asha P Shetty, Yashswi Untwale, Deepika Prajapati, Oshin Kharayat, Ratna Kumbhkar, Shashi Bala, Upasana
DOI:10.4103/IOPN.IOPN_4_19  
Background: Anxiety is a very common phenomenon which takes place in the patients before undergoing any medical / surgical procedure. Endoscopy procedures are usually done for the purpose of diagnosis and usually create anxiety in patients. Aims and Objectives: Study intended to find the level of anxiety in patients undergoing upper GI endoscopy and their association with demographic variables (Age, Marital Status, Gender, Education, Occupation, Residence and Family Income). Materials and Methods: Evaluative research approach and the quantitative descriptive research design used in the study. Total 56 Patients who were undergoing Upper Gastro Intestinal Endoscopy in Gastro OPD and Surgery OPD at AIIMS, Bhubaneswar were selected by a Non-probability purposive sampling technique. The tool used to obtain data were Demographic proforma and Beck's Anxiety Inventory. The tool was converted into Odia and the reliability established (α = 0.8) pilot study was conducted to see the feasibility of the study. Results: Total 49 (87.5%) of subjects experienced mild anxiety, whereas only 7 subjects (12.5%) experienced moderate anxiety and none of the subjects experienced no anxiety and severe anxiety. The data revealed that every individual experienced anxiety. There is no significance association was established between the demographic variables and the level of anxiety experienced by the individuals. Conclusion: All patients undergoing endoscopy, experienced mild to moderate level of anxiety. Nurses can adapt anxiety reduction guidelines prior to endoscopy to reduce level of anxiety to these patients.
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Effectiveness of a structured teaching program on the knowledge of emotional resilience among nursing undergraduates of a selected nursing college of Hyderabad p. 24
Anumol Joseph, PT Shiny, Pragati Robin
DOI:10.4103/IOPN.IOPN_9_19  
Background: Emotional resilience refers to one's ability to adapt to stressful situations or crises. More resilient people are able to “roll with the punches” and adapt to adversity without lasting difficulties; less resilient people have a harder time with stress and life changes, both major and minor. Objectives: The objectives of the study were to assess the effect of structured training program on knowledge of emotional resilience and to seek association between knowledge scores and selected demographic variables. Material and Methods: The research approach selected for the present study was a quantitative approach. A preexperimental research design was adapted with one-group pretest–posttest design. The study was conducted in a selected nursing college of Hyderabad. The sample size was 32. The sample chosen for the study was B.Sc. Nursing 1st-year students. Convenient sampling technique was used. A questionnaire with multiple-choice questions was prepared. Results: Majority of the students that is 16 (50%) who participated in the study were aged 18 years. Most of them belonged to nuclear family that is 25(78%). The pretest mean scores were 12.4 and the posttest mean scores were 16.5. Paired “t” test value was 18.6 and table value is 2.05 at 0.05 and the df is 31 which indicated that structured teaching was effective in improving knowledge of the students. There was no association between knowledge and selected demographic variables, such as age, religion, and type of family. Conclusion: It is during this novice period that they experience a lot of emotional upheavals and find it difficult to cope with trivial matters. The knowledge about emotional resilience will help them to face the challenges of life with optimism, and it would help them to use their problem-solving skills and to solve complex problems in life.
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Workplace empowerment of nursing professionals in healthcare industry p. 27
Rajalakshmi Ramu, BV Kathyayani
DOI:10.4103/IOPN.IOPN_11_19  
Background: Nurses have been called upon to lead and to be a partner in the transformation of healthcare Industry. Nurses and nurse managers must be empowered to perform their leadership roles to facilitate positive patient outcomes. Empowerment is possible when employees have access to information, support, resources, and the chance to discover and development. Aims and Objective: The aim was to investigate structural empowerment in nursing staff and to identify training needs to provide continuing education through workshop or conference. The objective of this study was to assess the level of empowerment of nurses working in hospital industry. Materials and Methods: A descriptive research design was adapted for the present study. A self-administrated questionnaire was distributed to the respondents on the basis of convenient sampling. Quantitative data were entered using SPSS version 17, and it was analyzed using descriptive statistics. Results: Majority of the respondents expressed that they empowered moderately. Conclusion: Empowerment of the nursing staff is very essential, and nursing administration must understand the importance of empowerment so that nursing professional can lead the hospitals effectively and facilitate the delivery of safe, high-quality patient care in hospitals.
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Comparison of attitude of smokeless tobacco users taking dental treatment versus not seeking dental treatment toward cessation of smokeless tobacco use p. 31
P Linda, Sandhya Gupta, Sonali Jhanjee, Vijay Prakash Mathur
DOI:10.4103/IOPN.IOPN_13_19  
Background: Tobacco exposure is the single greatest preventable cause of morbidity, disability, and mortality for chronic and debilitating diseases. In public health education, an important aspect is the treatment of tobacco use dependence. This experimental study is intended to deter the use of smokeless tobacco (ST) for the users who seek treatment and who do not seek treatment as well. Materials and Methods: The study was conducted using a pretest–posttest design on ST users (dental group = 40 and nondental group = 40) in a tertiary care setting. Educational video: A video film of 14 min was developed by a researcher that included contents related to the chemical properties of tobacco, its harmful health effects, the diseases caused by tobacco use, and the facilities available for treatment. Tools: The tools used were subject datasheet and attitude questionnaire. Results: The mean age of the participants in dental group was 39 years and in nondental group was 34 years. Most of the participants in dental group and nondental group were using gutka. Attitude scores of participants significantly increase from pretest (55.32 ± 7.0) to posttest (62.74 ± 4.2). There was a statistically significant difference between attitude scores of participants in dental group (60.3 ± 13.23) and nondental group (62.6 ± 4.19) at 1-month follow-up (P ≤ 0.05). Conclusion: The educational video film regarding the ill effects of tobacco use and its treatment was effective in enhancing positive attitude of both the equally useful.
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REVIEW ARTICLE Top

Mental health treatment – Still a Stigma and Concern in the 21st Century Stigma to appear normal, Stigma to keep the family drama invisibleStigma to protect the family honor, Stigma to coerce yourself out of the need for help p. 35
Shailla Cannie
DOI:10.4103/IOPN.IOPN_15_19  
People with mental disorders who live in low- and middle-income countries have low access to quality mental health care and are consequently vulnerable susceptible to suffering and incapacitation, human rights abuses, stigma and discrimination, impoverishment, and premature mortality. The more a mentally ill person feels stigmatized; the lower is their self-esteem, convivial adjustment, and quality of life. The aim of the review is to explore the stigma of mental illness and mental heath services in low and middle-income countries. A PubMed and open-access database literature search (English only) was performed using search strings: stigma of mental illness, Ghana's mental health system, community psychiatry in India, mental health awareness in Nigeria, psychiatric stigma and discrimination in South Africa, and stigma and community intervention. Mental health workforce in India is a shortfall of specialist and psychiatric social worker for mental illness; treatment is unavailable or inaccessible even for those who actively seek health care. In Ethiopia, mental health services coverage and financial auspice for people with mental disorders are constrained. In low- and middle-income countries, the causative agent for mental illness in the current decade is still supernatural power or agents and serves as a major barrier to the treatment. The interventions have the potential to reduce stigma in society at large with the appropriate planning and evaluation. Mental health is still a taboo, and no one acknowledges it. The review demonstrates an adaptation to utilize and participate in mental health care facilities remains a policy aspiration, which generally has not been translated into clinical practice.
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CONCEPT ARTICLES Top

Indians richer but less happy today, here the plausible five reasons why? p. 39
K Sagar
DOI:10.4103/IOPN.IOPN_12_19  
India has been ranked 133rd among 156 countries in the United Nations' World Happiness Report 2018, 15 places down from its position in 2015. This is despite the report's finding that India's per capita gross domestic product (GDP), a measure of the standard of living, and healthy life expectancy, a marker of well-being, have trended upward over the last 3 years. At the same time, socioeconomic inequity is preventing per capita GDP growth from translating into happier people. This is not to say that higher income does not matter. However, once these needs are fulfilled, they stop experiencing greater happiness with rising income if there is also growing inequality, as it leads to unfavorable comparisons. In the last 3 years, Indians have reported experiencing fewer positive emotions and more negative emotions, two variables that influence the World Happiness Ranking. Did you experience happiness and enjoyment during a greater part of yesterday? Did you smile or laugh a lot yesterday? Participants' responses to these questions made up the positive emotion variable, called “positive affect.” To what extent did you experience worry, sadness, and anger yesterday? Participants' responses to this question made up the negative emotion variable, called the “negative affect.” Here, in this article, there are five plausible reasons how happiness eludes India. However, we have a long way to go. These happiness rankings remind the loopholes in our system. India needs to work faster to reduce inequality and to ensure freedom and well-being. Happiness ministry is the need of the hour in India.
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Community-based management of opioid use disorder: Role of nursing professionals and paramedical workers p. 43
Naveen Dhagudu, Snehil Gupta, Roshan Bhad, Ravindra Rao
DOI:10.4103/IOPN.IOPN_14_19  
Magnitude of the opioid use problem is high globally, as well as in the India, as has been reported in various global and national epidemiological surveys on substance use disorder. There is a marked gap between the burden of substance use problems, particularly opioid use-related problems, and treatment services. Many international organizations have recommended an integrated model of treatment to overcome this gap. Community-based treatment services help in catering to the large population of the opioid using individuals, especially the hidden, marginalized population. The newer model of low threshold approach to treatment has gained popularity among the opioid using population. Further, it plays a significant role in reducing stigma attached to opioid users and also enhances treatment seeking. Community opioid use treatment setups, being located in the community itself, are in unique position to promote community participation and integrate local resources. Such treatment centers play a crucial role in promotive, preventive, therapeutic, and rehabilitative services for individuals with opioid use problems. Paramedical staff/nursing staff play a significant role in providing opioid use treatment services such as supervised dispensing, observing signs of opioid withdrawal and also of intoxication, intervening in case of opioid overdose, and also acting as bridge between the treatment-seeking population and the specialist doctor.
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Maternal mental health and role of nurse p. 49
Sandhya Gupta
DOI:10.4103/IOPN.IOPN_16_19  
One in five women suffers from depression, anxiety, or both while pregnant or after giving birth, negatively impacting the mother and the child. Despite this high prevalence of mental health issues, few women receive treatment. Health workers working with pregnant and lactating women need to better understand this issue and to explore innovative, practical solutions for delivering mental healthcare to mothers and expectant mothers in need. They include prenatal and postpartum depression and/or anxiety. Conclusion: Overall, psychosocial and psychological interventions are effective treatments for postpartum depression. All interventions have to be face to face and provided by a health professional.
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Models and roles in National Mental Health Programme p. 52
G Balamurugan, G Radhakrishnan, M Vijayarani
DOI:10.4103/IOPN.IOPN_18_19  
In India, National Mental Health Programme (NMHP) was started in 1982 with the primary objectives of ensuring availability and accessibility of minimum mental healthcare for all. In 1985, National Institute of Mental Health and Neuro Sciences, Bengaluru, had developed Bellary model of District Mental Health Programme (DMHP), to achieve the objectives of National Mental Health Programme (NHMP). The current DMHP has more scope for the nurses to deliver mental health services as psychiatric nurse and community nurse. Hardly, one-third of districts in India are covered under DMHP and the service utilization is also to be strengthened. Psychiatric nurses have greater scope to transform all these existing challenges into opportunities.
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