12^th Nursing and Healthcare Congress October 03-05, 2016 Vancouver, Canada

Sinem Göral Türkcü works as a Research Assistant in Pamukkale University, Faculty of Health Sciences, Department of Obstetrics Gynecology Nursing in Denizli, Turkey. She is a PhD student at the same university.

Aim: This study was conducted to determine the effect of urinary incontinence on the life quality of women living in nursing homes in the Mediterranean region. Materials and Methods: The study was conducted on 95 women living in nursing homes in the Mediterranean region. Data were collected by using a questionnaire to gather socio-demographic characteristics, the Urinary Incontinence Quality of Life Scale (I-QOL) to evaluate women’s life quality, the Index of Activities of Daily Living to evaluate the dependence of patients while performing their daily living activities, and the International Consultation on Incontinence Questionnaire short form to determine the urinary incontinence type. Results: Quality of life of those who did not consider urinary incontinence a health problem was significantly higher than that of those who considered otherwise. Mixed urinary incontinence was the most common urinary incontinence type among the women living in nursing homes with a rate of 31.7%. According to the overall mean scores of the I-QOL scale, life quality was the most affected among women who had nocturnal incontinence. Life quality was followed by the mixed type, stress type, and urge type of incontinence. Conclusion: Early diagnosis and treatment of urinary incontinence could be conducted through trainings provided by health personnel who have a unique role in changing the perception in society. Identifying this problem and determining and preventing the risk factors are important to enhance the quality of life of women.

Yu-Hua Yan is a PhD in Graduate Institute of Management from the National Kaohsiung First University of Science and Technology, Taiwan, R. O. C. She is the Senior Specialist at Tainan Municipal Hospital, Tainan County, Taiwan, R. O. C. Her research interests include watermarking, health care industry and management performance. Most academic work is published in Health Policy, Journal of Nursing Research, Asia-Pacific Journal of Clinical Oncology, Asian Pacific Journal of Cancer Prevention and other Journals.

Purpose: This study aims to explore the relevance among interaction, trust, co-decision-making, information disclosure and value co-creation from the perspective of service-dominant logic. Method: Questionnaires were given to the hospitalized patients of a regional hospital. A total of 232 questionnaires were received. The statistical software of the least squares method was used to examine the applicability of measurement patterns. Result: “Interaction” (β=0.197, p<0.001), “trust” (β=0.248, p<0.001) and “co-decision-making” (β=0.143, p<0.05) positively affect value co-creation while “information disclosure” (β=-0.079) does not have a significant effect. Conclusion: Service-dominant logic is the interaction and value co-creation between the service provider and receiver, and it is thus suggested that the interaction and trust building between doctors and patients and the provision of patient-centered service be encouraged. In the medical service value network, the interaction, trust and co-decision-making of doctors and patients are established with an aim of integrating medical service resources in order to fulfill the service-dominant logic purpose of value co-creation.

Sooja Kim has completed her PhD from Kawasaki University of Medical Welfare. She is an Associated Professor of Kanagawa University of Human Services, School of Nursing.

Aim: The first phase of this interview survey was conducted to detect health warning signs of people with ID having difficulty of expressing their symptoms by their family in the community. Method: A metropolitan area was chosen (Area Z) in which the ID population ratio was similar to the national average. Following consent from seven parents of two workplaces for people with ID in Area Z, their interviews were analyzed using qualitative inductive analysis. Results: The subjects’ families with ID were five males and two females in the 20’s to 50 are, with ID ranging from mild to severe. The parents noticed only slight differences in the usual health states of their family members with ID in their complexions, facial expressions, appetite, appearance of listlessness, and their unusual silence. The signs easily observed as health warning by the parents were cough, runny nose, extreme body temperatures, and frequency of toilet use, diarrhea, and vomiting. It was difficult for the families to detect where the individuals with ID felt pain, or to assess the degree of the pain, or to forecast sudden vomiting, or to observe excrement prior to their flushing the toilet. Conclusion: Not only do we need to focus on how to detect unnoticeable health warning signs of individuals with ID, but also further focus on how to communicate the subtle nuances that can help distinguish abnormalities in the usual state of health.

Shu-Chen Hsing was born in Kaohsing,Taiwan,R.O.C. She is a Master Graduate Institute of Department of Hospital and Health Care Administration Chia-Nan University of Pharmacy and Science Taiwan,R.O.C ,She is a respiratory therapist at Chi Mei Medical Center respiratory department section chief.

Background: Magnetic resonance imaging (MRI) is a very common examination for the patients in critical illness with mechanical ventilation, however, non-metallic equipment allow of these patients was instructed to prevent sucked accidence of the metallic equipment into the magnetic bore of MRI scanner. Aim: For patient’s safety, the interaction between the MRIs magnetic force and metal ventilators were investigated, and a safety area was confirmed by two marked lines to prevent the sucked accidence of ventilators. Materials & Methods: The strength of a magnetic field of MRI scanner is measured in Gauss Units (Gs). Two MRI instrument; one is from Siemens 1.5T MRI, Germany, and the other from General Electric Company (GE) 3.0T MRI 2 (USA). Two Ventilator; one is traditional SERVO VENTILATOR 900C (900C), the other is MAQUET SERVO-i MR Environment (SERVO-i). The magnetic force of MRIs were detected and the colored tapes were used to mark for the prohibited, alerted, and safety areas. Results: Traditional metallic Servo 900C is not recommended for the patients with mechanical ventilation to perform the 1.5 T MRI exam, however, some reports showed that it can be set up in an area less than 20Gs magnetic force. Therefore, a marked line for a “prohibited area” that more than 20Gs magnetic force was detected to exclude the metallic equipment parking. Another marked line for an alert area with magnetic force between 10-20 Gs, where the metallic equipment should be placed with great carefully. Also a “safety area” with less than 10Gs magnetic force was confirmed, where the metallic ventilator can be placed safety. After enter the 1.5T MRI room, the Servo 900C should be placed inside the safety frame initially, than process the power supply and setting up. On the other hand, traditional Servo 900C can’t place even enter in the new 3T MRI room, according the instruction of 3T MRI operation, a certified MRI compatible ventilator (SERVO-i) is recommend for patients with respiratory failure, also a prohibited line with 200Gs should be marked. According to the instruction of operation of 3T MRI, a safety area beyond the prohibited line with less 200 Gs magnetic force may consider to be safety without sucked accidence to place the SERVO-I (Figure 2). However, according to the operative guidelines of SERVO-1, an area with less than 50Gs should be considered complete safety for a patient under Servo-1 ventilation, thus whether a safety area to place the SERVO-I beyond the line of 200Gs or 50 Gs is depended on requirement of each MRI center. Conclusion: When setting up a mechanical ventilator for a patient to perform the MRI study, be sure to obey the operative guidelines of MRI scanners. The marked line for a safety area and a safety frame to place the ventilators is very important to prevent the sucked accidence for the metallic equipment. These lines may promote the patient safety for clinicians.

Yu-Hsia Wang was born in Tainan,Taiwan,R.O.C. She is a Master Graduate Institute of Department of Hospital and Health Care Administration Chia-Nan University of Pharmacy and Science Taiwan,R.O.C ,She is a Nurse at Tainan Municipal Hospital Nursing Department Nursing Supervisor.

Background: Due to growth of the national income and increase of the medical knowledge among the general population, people are paying much more attention to healthcare quality. Offering medical service of higher quality is an important strategy in the competitive environment among hospitals. The management of hospital must understand the real needs of patients and provide them with good medical service accordingly, so they can gain trust and loyalty from patients. This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the medical institution. Methods: Data used in this study were obtained through a national telephone survey by random sampling. Results: Results of the latest survey conducted by the National Health Insurance Administration (NHIA) in 2015 showed that 81% of respondents were satisfied with the program, an increase of 1.3% from 2014. Members of the public were particularly satisfied with the reduced cost of medical care and the convenient access to medical services. On the other hand, 14.1% of respondents indicated dissatisfaction, citing reasons such as the high premium and the wasteful use of medical resources and medication. Nevertheless, dissatisfaction with how supplementary premium is calculated and people's attitude toward medical services both dropped by 2% to 3% from last year. Up to 85.1% of respondents were satisfied with the medical services provided at NHI-contracted healthcare facilities. The good service and attitude of healthcare professionals, in particular, secured the highest degree of satisfaction. Conclusion: Based on the study result, we as treatment provider should improve our quality of medical care and treatment outcome for patient satisfaction as well as patient loyalty. It is hoped that the above results can serve as future reference for the management and operation of medical institution.

Background: Cervical cancer is one of the leading cancer killers among women all over the world. Cervical cancer is the most common female cancer in developing countries, a woman die of cervical cancer every two minutes. Its contribution to cancer burden is significant across all cultures and economies. However in Nigeria this disease is still killing up to 8,000 women annually. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilized. Aim: The aim of this research is to assess the knowledge of cervical cancer screening among Nigerian women. Methods: A descriptive cross-sectional survey was adopted to assess the knowledge of cervical cancer screening among women attending Adeoyo Maternity Teaching Hospital in Ibadan North Local Government of Oyo State. The sampling technique adopted in the study was the simple random sampling. The respondents were reassured of the confidentiality of the data. The instrument used basically was self-structured questionnaire. Data were analyzed using descriptive statistics and chi-square. Results: Respondents’ mean age was 26.0±1.5 years,40.8% had primary education, 54% of the respondents were self employed,55% were Muslim by religion, majority were Yoruba (51.5%) had between 1 and 2 children, 26% of them practice polygamy.55.4% of the respondents understood that it is a malignant growth of the cell. Common sources of information were clinics (48.5%) and media (23.1%). 52.3% of the respondents were not aware that the screening centre was at their locality. Thirty-eight (38%) of the respondents reported that Pap smear should be done between 1 to 3 years, only 26(20%) out of 130 respondents have done pap smear before.75.4% had poor knowledge of prevention of cervical cancer. The relationship between source of awareness of cervical cancer and knowledge of Pap smear was not significant (p>0.72), 73.7% of the respondents that had poor knowledge of prevention had primary educational background but there was no significant relationship between the educational status and the knowledge of the prevention of cervical cancer (p>0.86). Conclusion: Knowledge about the cervical cancer was fair, but respondents had poor knowledge about the Pap smear and the overall uptake of the cervical screening was low among the respondents. Incorporating periodic health publicity programmes in the market, religious setting and working places will improve the knowledge and uptake of the cervical screening.

Mami Onishi has completed her PhD from Tokyo University. She is an Associate Professor of Nursing Administration. She has published papers on team management and staff development in nursing management journals.

Staff development for hospital nurses is a major concern for nurse administrators and managers. In Japanese hospitals, staff development nurses contribute to planning and managing staff education and career development. However, there are few educational programs for staff development nurses in Japan. Well-designed educational programs for staff development nurses would be effective at enhancing the quality of staff development in nursing. This study aimed to investigate the current status of staff development nurses’ work and their educational needs in Japan to design a program for educating staff development nurses. We administered a cross-sectional survey to 281 randomly selected certified nurse administrators. The questionnaire was designed based on the literature and group interviews, and it concerned the roles of staff development nurses and methods employed in staff development processes, such as needs assessments, educational sessions, and effectiveness evaluations. Responses were obtained from 101 nurse administrators, 60% of whom worked in a hospital with a full-time staff development nurse. Eighty percent of the participants responded that their staff development nurse was actively engaged in assessing nurses’ needs and in planning, operating, and evaluating educational programs. The most frequently used method for evaluating the effectiveness of the educational program was learners’ perceptions. Participants perceived that staff development nurses should strengthen the emphasis on assessing learners’ needs and evaluating programs. The most frequently mentioned skills important for staff development nurses were planning, data analysis, and analytical thinking. The skills involved in educating individuals, such as facilitation and coaching were also perceived as important.

Mayumi Chikubu is a student at the Kyushu University Graduate school of Medical Sciences doctoral course now. In addition, she completed a Master’s course (nursing science). Her study theme is human resources development and perioperative nursing. She has nursing license and has the experience of the clinical nursing of 29 years. She is working at University of Miyazaki Hospital and is a certified wound, ostomy, and continence nurse in Japan.

This study clarified the competency elements in role accomplishment of certified wound, ostomy, and continence nurses (WOCNs) in Japan. In this study, WOCNs were defined as expert WOCNs who had worked more than five years as certified nurses. Expert WOCNs provided a WOCN competency model of development. The investigation examined 27 WOCNs who worked at a hospital. The investigation was conducted by interview. The interview was from 45 minutes to 120 minutes. Data about competency were collected through semi-structured interviews. As a result of categorizing and analyzing the collected data, five categories of competency elements in WOCNs’ role accomplishment were extracted: “action required to achieve the job objective,” “skills in the WOC nursing practice model,” “human relationships based on understanding others,” “WOCN role formation,” and “WOCN self-study.” These will lead to growth and development as WOCNs gain clinical experience according to expert guides.

Elinor Nielsen is specialist operation theater nurse since 1989 and often is responsible of patients undergoing surgery in local anesthesia.

Background: Patients going through surgery in local anesthesia often have a sense of anxiety and stress and thus need support to relax. Different distracting intervention is known to reduce the anxiety and stress. Pictures of the nature, has to our knowledge not been used to support patients comfort during surgery in local anesthesia. Purpose: The aim was to evaluate the effects of looking at pictures of the nature on patients’ experience of anxiety, relaxation, well-being, and pain during elective surgery in local anesthesia. Design: A three-armed randomized intervention was performed at three different hospitals. Methods: Adult patients undergoing surgery in local anesthesia were consecutively randomized into three groups, one group looking at pictures of the nature on an Ipad, one group listening to sedative instrumental music and one control group receiving ordinary care during surgery. State Trait Anxiety Inventory (STAI) short form was filled in before the surgery and just before discharge STAI and VAS-scales on anxiety, relaxation, well-being, and pain were filled in. Preliminary results: Patients n=240 (54% women), with a mean age of 58 (±17) years participated in the study. There was no difference between the three groups related to anxiety after surgery. Younger patients had significantly higher degree of anxiety and lower degree of relaxation and wellbeing (p<0.05), postoperatively. Conclusion: Looking at pictures of nature during surgery in local anesthesia is as relaxing as listening to sedative instrumental music. Offering patients to look at nature pictures could be a complement to listening to music.

Gunilla Hollman Frisman is specialist intensive care nurse, has completed her PhD, 2003, and the assistant Professor 2010, at the Medical faculty, Linköping University, Sweden. She has published more than 25 papers in peer reviewed international journals and has been serving as an Editorial Board Member of reviews.

Background: Patients going through surgery in local anesthesia often have a sense of anxiety and stress and thus need support to relax. Different distracting intervention is known to reduce the anxiety and stress. Pictures of the nature, has to our knowledge not been used to support patients comfort during surgery in local anesthesia. Purpose: The aim was to evaluate the effects of looking at pictures of the nature on patients’ experience of anxiety, relaxation, well-being, and pain during elective surgery in local anesthesia. Design: A three-armed randomized intervention was performed at three different hospitals. Methods: Adult patients undergoing surgery in local anesthesia were consecutively randomized into three groups, one group looking at pictures of the nature on an Ipad, one group listening to sedative instrumental music and one control group receiving ordinary care during surgery. State Trait Anxiety Inventory (STAI) short form was filled in before the surgery and just before discharge STAI and VAS-scales on anxiety, relaxation, well-being, and pain were filled in. Preliminary results: Patients n=240 (54% women), with a mean age of 58 (±17) years participated in the study. There was no difference between the three groups related to anxiety after surgery. Younger patients had significantly higher degree of anxiety and lower degree of relaxation and wellbeing (p<0.05), postoperatively. Conclusion: Looking at pictures of nature during surgery in local anesthesia is as relaxing as listening to sedative instrumental music. Offering patients to look at nature pictures could be a complement to listening to music.

Anna-Clara Rullander has completed her PhD at Umea University in Sweden, defending her thesis in December 2015. She is now planning postdoctoral studies in the area of scoliosis surgery and interventions aimed at optimizing peri-operative care. She has published four articles and presented her research at five international conferences.

Scoliosis surgery is a major surgical procedure and it is known to cause severe postoperative pain. To broaden the scope of adolescents’ experiences of undergoing scoliosis surgery and the trajectory of self-reported pain during the hospital-stay and through the first six months of recovery at home after corrective surgery a mixed methods study was performed. Interviews, diaries and self-reports of pain were analyzed and integrated with each other. The results indicate that the trajectory of pain varies hugely between individuals. The adolescents experienced physical suffering and struggled not to be overwhelmed. Supportive factors and how they were trying to cope with difficulties were described. The adolescents described how they were hovering between suffering and control and they strived towards normality. Interviewing adolescents about earlier experiences, coping strategies, fears and expectations about surgery can be a useful tool for nurse to understand individual needs and enabling improved individual care: a step towards personal centered care. This study highlights areas of potential improvement in peri-operative scoliosis care in terms of nursing support and pain management.

Sedigheh Pakseresht has completed her PhD at the Delhi University in 2009. She is an Associate Professor at Department of Obstetrics, Women Health Promotion, Community Health (PhD), Obstetrics (MSc), English Teaching (MBA). She is Editor in Chief in Holistic Nursing and Midwifery Journal, Member of Reproductive Health Research Center and Social determined on Health Research Centre at Guilan University of medical sciences, Rasht, Iran. She has published more than 32 papers in Iranian journals and international journals in ISI and other levels as well. She has been serving as an Editorial Board Member also. She has presented more than 15 papers in international conferences, the latest was in Washington DC 16-19 April in 2015.

Onset of menstruation (Menarche) is one of the most important phenomena in female maturation process. Several factors contribute to the age of menarche. The purpose of this study was to investigate the relation between menarche age and environmental factors in students aged 11-14. In this cross-sectional study, 651 elementary and middle schools` girls (students) aged 11-14 years old in Rasht, Iran in 2014 were selected by cluster randomly sampling. Data were collected by questionnaire. Some environmental factors assisted in this study. Data were analyzed by using SPSS software version 20 and descriptive and analytics statistics were presented. In this study all statistical tests were done to determine any significant differences at 5% level. Mean and Standard deviation age at onset of menarche was 12.093±0.051years. There were significant differences in using mobile (P=.0001), computer (P=.0001), frequency of use of mobiles during the week (P=.003), daily using of a mobile (P=.000), longtime of using mobile during the day (P=.000), daily using of computer (P=.001), computer (P=.001), longtime of using computer during a day (P=.000) and even exercise (P=.0001). Also, significant difference was observed between age of onset of menarche with seasons (P=.0001). There were not significant differences with other variables. The results indicated that environmental factors influence the phenomena of menarche in girls. Recently, technology usage is developing more and more in all the levels especially in younger ages, so giving proper knowledge and preparing health program for them should be started in the early times.