Effectiveness of Guidelines on Myocardial Self-Care

Effectiveness of Guidelines on Myocardial Self-Care ASSESS THE EFFECTIVENESS OF HEALTH GUIDELINE ON SELF CARE FOR MYOCARDIAL INFARCTION PATIENTS. Patel Asha N.   Abstract: Heart disease is first of the largest killer diseases in the world. According world health organization estimated 17 million people worldwide coronary vascular disease. In developing country the cost of bypass surgery and angioplasty is very high. every person cannot affordable for taking treatment. this study helps to patient about self care precaution and awareness of disease and its minimizes the further complication. This study helps to myocardial infarction patient to improve their health. This study is a experimental study. The population of this study consists of medical college attached government hospitals in Gujarat state. This stydy include the 35 samples in male and female. A structured questioner tool is prepared for assessing the knowledge including six component (self care, modifications, exercise, pulse monitoring, diet, stress reduction technique) and check list, ratings scale prepared for assessing the performance of their activities(pulse monitoring, musc le starching exercise, stress reduction technique) the finding is indicated that health guideline is very effective for the MI patient to improving their health and healthy life style. Key words: Effectiveness, Health guideline, Myocardial infarction, Performance rating scale observational check list. Introduction: The widely accepted definition of â€Å"WHO† in 1948 in preamble to its constitution which is follows â€Å"Health† is a state of complete physical, mental and social well being and not merely absence of any disease or infirmity†. So according to W.H. O. health cannot be defined as a ‘state’ but it must been as a process of continue adjustment to the changing meaning which we give to life. This is a dynamic concept. Heart disease is first of the largest killer disease in the world. Cardiovascular disease are major contributors to the global burden of chronic disease with 29.3% of global deaths and 9.9% of total disease burden, in terms of disability- adjusted life years lost, being reported in 2003. Low and middle income countries accounted for 78% and 86% of the CVD deaths and daily lost, respectively, worldwide in 1998. In India CVD is projected to be the largest cause of death and disability by 2020 with 2.6 million Indians predicted to die due to coronary heart disease, each consist 54.1% of all CVD deaths. In resent year education has come to be considered as an integral component of health care. The modern philosophy of health care in every society take in to consideration the physical, special for diet, psychological and socio cultural environment and other thing in that stress management using many technique like mediation, relaxation etc. MI is a chronic life long illness. The basic component of self care applies to all cardiac patients but the care must be designed to fit each person individual needs and habits. In order to meet learning needs of the patients, prepare health guideline on self care activities for the promotion of the health, prevention of further risk or complication, early diagnosis and treatment of the disease. It aims at the modification of life style – change in diet, regular exercise, avoid smoking and avoid alcohol and stress management for preventing health crisis. Objectives of the study To assess the knowledge of self care on myocardial infarction before and after introducing health guideline and demonstration on self care activates to myocardial patients admitted in medical ward in medical college attached government hospitals in Gujarat state. To assess the performance of self care on myocardial infarction before and after introducing health guideline and demonstration on self care activates to myocardial patients admitted in medical ward in medical college attached government hospitals in Gujarat state. Literature reviewed: Important education after myocardial infarction: Duryee R, â€Å" The efficiency of inpatient educational after myocardial infarction in that the educating the patient who has experienced a MI has long been a challenge for the professional nurse. Nurse has prepared volumes of teaching materials to enlighten the patient who has experienced an MI. the purpose of this study was to review the research literature on in- patient education after MI published between 1975 and 1983 the review of 21 studies to determine what information is most important to patients whether inpatient teaching increase patient knowledge, whether lifestyle changes are affected by education and which instructional methods were most effective. Multiple teaching methods were used across the 21 studies reviewed: individual and group session led by nurse rehabilitators, slide sound presentation, videotape sessions with a nurse. The studies demonstrated that audiovisual methods are as effective as presentations by an educator. Important of diet for heart disease. Miss Saramma Jacob â€Å"A study of the knowledge of the patients and the relatives about the importance of salt restricted diet as a therapy in some heart disease†. This study was designed to explore the knowledge of the patients and the relatives about the importance of salt restriction and also the importance of using the prescribed amount of salt. Through this of study it was found that knowledge of this patient and the relatives about the importance of salt restricted diet as a therapy and the relatives about the importance of salt restricted diet as a therapy in some of the heart disease has increased 10% to 70% proper explanation and teaching about the important of salt restricted diet is the reason for this increase in knowledge. All patients used the prescribed amount of salt within one day when they realized the importance. Robertson d and keller C. â€Å" Relationship among health beliefs. Self efficiency and exercise adherence in patients with coronary artery disease.† Many nursing care hours are dedicated to educating patients with coronary artery disease about their disease process and requisites life style changes in order to maximize life expectancy. New therapies may abort life threatening events, however control of the progression of coronary artery disease is ultimately dependent upon the patient’s cooperation in modifying risk factors. Too often health care recommendations go unheeded. The purpose of this study was to develop a model that would explain relationship among several variables that determined adherence to an exercise regimen. The variables were chosen from the health belief model and self efficiency theory. Study findings revealed a significant positive correlation between activity and perceived benefits and between activity and perceived self efficiency. There was si gnificant negative relationship between activities and perceived barriers. Hypotheses: The mean post test knowledge scores of self care of myocardial infarction patients will be significantly higher than their mean pretest scores at 0.05 level. The mean post test of self care activities scores of self care of myocardial infarction patients will be significantly higher than their mean pretest scores at 0.05 level. Operational definition Effectiveness: It refers to the power of the bringing a change in the knowledge and activities of myocardial infarction patients regarding self care activities after the administration of health guide line and demonstration of exercise from the knowledge and performance scores. Knowledge: It refers to the myocardial patients for correct responses regarding self care activities on the structured knowledge test item and evidence from knowledge score. Activities: It refers to the myocardial infarction patient’s ability to perform activities regarding pulse monitoring muscle stretching exercise, stress reduction technique and tool as evidence from structured observational checklist and performance rating scale. Self care: Those health generating activities that are undertaken by the person themselves. Delimitation: Investigator includes only medical college attached government hospitals. Investigation take only hemodynamic stable myocardial infarction patient. Methodology: The present study is a quai experimental study. The methodology presents the population of the study, sample of the study, tools and technique used in this study, data collection, and plan for analysis. POPULATION: the population of this study consists of MI patient admitted in medical college attached Government hospitals in Gujarat state. SAMPLE AND SAMPLING TECHNIQUE: patient who has a Myocardial infarction and hemodynamic stable admitted in medical ward. Researcher take the 35 sample that were use the purposive sampling method. TOOL USED: the investigator has prepared tool for to check knowledge as well as activities of MI patients regarding self care. For to check the knowledge she prepared structured questionnaire and for observe the practices she prepared observational checklist and performance rating scale. PROCEDURE FOR DATA ANALYSIS : for testing the hypothesis of the study the investigator analyze the data using frequency, percentage, standard deviation, ‘t’ test and correlation. ANALYSIS AND DISCUSSION: The data were tabulated, analyzed in terms of objectives of the study. Descriptive statically methods were employed for the analysis of tool. in that knowledge area mainly six area those are the related to self care, medicine, exercise, pulse monitoring, diet, stress reduction technique. Through the analysis and interpretation of data, researcher has described following major findings of the study. Findings related to knowledge and activities area:There was maximum gain of knowledge in exercise area. In the exercise area mean percentage of pretest was 11.4% and mean percentage of post test was 78.97%. It indicates that the 67.55% gain in area. According to the table it is the highest gain. Findings of sample related to knowledge of diet :There was minimum gain in the area ‘diet’. In this area mean percentage of pre test was 61.42%whereas mean percentage of post test was 99.28% which suggests that 37.86% gain in the area. Findings of sample related to activates of the self care, stress reducing exercise and pulse monitoring: There are 62.94% and 62.87% gain in area ‘ medications’ and ‘ pulse monitoring respectively. They are 2nd and 3rd in gain after the exercise. There was approximately equal gain in self care and stress reduction technique and providing information areas. It was 45.71% and 45.75% respectively. Finding of sample related to muscle starching exercise: There was maximum mean percentage of post test in muscle starching exercise All over the knowledge score of MI patients before exposing the health guideline and demonstration, mean score of the sample was 3.14 after exposing the health guideline and demonstration, mean score of the sample was 8.11 the difference in knowledge and act score suggesting the knowledge gain by sample. Interpretation through comparing the mean percentage of pre and post performance test in each task. The data suggest that there was maximum gain in pulse monitoring it was 68.93%gain. There was 57.66 % gain in stress reduction technique and 59.61% gain in muscle starching exercise. It indicate the mean 8.6 score obtained by sample before demonstrate the activities and 34.2 score obtained after demonstrating the activities. to the myocardial infarction patients. Conclusion: Knowledge deficit existed in all area of self care among samples admitted in medical ward in medical college attached government hospital in Gujarat state. The study in terms of health guideline and demonstration was found to be effective in enhancing the knowledge and skill of the samples regarding self care activities. IMPLICATIONS AND UTILIZATIONS The findings of the study have several implications in the nursing practice, nursing education, nursing administration and nursing research. Nursing practice: the study is relevant for nursing professional working in the area of cardiac center in the Indian setting. Nursing personal should plan teaching programmes and provide adequate information and guidance to such client who have myocardial infarction disease and they enhance their self care ability. Nursing education: skill development is an essential component of professional life. The responsibility of instructor is in meeting learner’s need in acquiring relevant knowledge to underpin the development skills. Attempts should be made to ensure that the learner is taught in such a way that it allows them to construct learning in a simulated context and then apply it into real situation. The focus should be on the learner under standing the process of acquisition rather than performance. They should develop health guideline, self instructional module , audio- visual materials, booklet, pamphlet i.e. video, tap, slides etc. on cardiac self care for utilize them for teaching learning activities. Nursing administration: the expressed learning need of client can be considered as indicator for planning structured health programmes. nursing administration should promote and support preparation of such instructional material by nursing personnel and they should be educationally prepared at different levels to undertake such endeavors in order to assist clients, and the community in developing their self care potentials. Nursing research: self care is a fundamental therapy for cardiac patients. Many questions remain to be answered about it. Research is needed to identify the optima ways to teach self care activities to cardiac patients. Nurses are available at all the time ti the patients in hospital. Research should be directed to exploring the nurses knowledge regarding self care of myocardial infarction patients or other cardiac diseases. There should be research studies conducted in different setting and on large sample. RECOMMENDATIONS: The following recommendations are made on the basis of the findings of the present study. A study can be replicated on a large sample, their findings can be generalized for a large population. Similar study can be conducted on nursing student. A study can be conducted develop and evaluate a self guideline n the form of pictorial booklet/ pamphlet for the illiterate group. A comparative study can be conducted for the two groups. One group gives the treatment and other group is control group. A study can be conducted to identify life style of the cardiac patients. Reference Website: www.Cardiac home care.org www.Self care of myocardial patient.org www.diet for cardiac patients.com www.excercise for cardiac patient.com www.guideline for cardiac patient.com Journals: Bennet sj, Savue MJ â€Å" cognitive deficits among patients with heart failure†. A review of literature J. cardiovascular nurse2003. Cardiac nurse preparedness to use self help groups as a support strategy. Journal of America nursing 1995, vol 22 p 921- 928 Heart facts dallas TX; American heart association;2005 Books: Alexander R.W. and schant, Textbook of heart.8th edition, health professional division, new York: 1998 Black J.M. Medical Surgical Nursing. 5th edition W.B. Saunders company, Philadelphia: 1999 Dossey B.G. Guzzetta C.E. â€Å" Critical care nursing Body- mind- Spirit ,3rd edition, J.B. Lippincott: Philadelphia ; 1996

Principle of Management Essay

From Scientific to Administrative Back around 1860, Henri Fayol, a then-young engineer, began working at a coal mine in France. While working at the mines, he noticed that managing the miners was not an easy job. Managing was not as effective as it could be. Managers had few resources and tools to better manage people. At the time, Frederick Winslow Taylor, founder of the school of scientific management, was making strides in maximizing productivity by focusing on the work and worker relationship. In other words, Taylor believed that there was a science to work. If workers worked more like machines, there would be increased productivity. Frederick Winslow Taylor founded the school of scientific management Unlike Taylor’s scientific management theory, Fayol believed that it was more than just work and workers. Managers needed specific roles in order to manage work and workers. This became known as the administrative school of management and was founded on the six functions, or roles, of management: 1.Forecasting 2.Planning 3.Organizing 4.Commanding 5.Coordinating 6.Controlling Principles 1-7 These roles, used as a process, focused on the entire organization rather than just the work. Once broken down into smaller parts, the six functions evolved into Fayol’s 14 Principles of Management. In this lesson, we will focus on the first seven principles: 1.Division of Work 2.Authority 3.Discipline 4.Unity of Command 5.Unity of Direction 6.Subordination of Individual Interests to the General Interest 7.Remuneration While Fayol’s 14 Principles of Management are not as widely used as they once were, it is important to understand how the foundation of administrative management theory was developed to address the needs of the times. This macro approach was the first of its time. Let’s not forget, Taylor did not focus on the human element. Henri Fayols principles of management focus on the human element His scientific approach to work focused on building a better, stronger, faster and more productive team through physical elements. Fayol didn’t see it that way. Fayol saw workers as humans possessing elements that required a more general approach to getting the work done. He saw it as a whole organizational effort. Principles Explained Let’s take each principle and use examples to better understand how these principles work together to create an administrative management mindset. Let’s use Fayol and the Principles, a rock band, to help us better understand the first seven of the 14 Principles of Management. 1. Division of Work: When employees are specialized, output can increase because they become increasingly skilled and efficient. Fayol and the Principles is made up of four members, including Fayol. Each band member specializes in a specific instrument or talent. Fayol is the lead singer, while the other members play instruments. The band is able to produce quality music because each performs the job in the band that he or she is most specialized in. If we were to mix it up a bit and put Fayol on bass guitar and another member on singing – neither of whom possesses the skill to perform the job – the sound would be much different. 2. Authority: Managers must have the authority to give orders, but they must also keep in mind that with authority comes responsibility. Fayol and the Principles understand that they should specialize in their specific areas; however, there needs to be a leader. Fayol assumes the role as leader and gives everyone orders. He says ‘Play this. Do that.’ But with that comes responsibility. He knows that, whatever task he delegates to the band, he must make sure that the task is completed, that the task is done in a productive way and that it yields results. 3. Discipline: Discipline must be upheld in organizations, but methods for doing so can vary. From time to time, the band members do not perform to Fayol’s standard. Even though Fayol looks at the organization as a whole organizational effort, he also knows that he must administer discipline for ineffectiveness. Two of Fayol’s band members decided to take a break from practice to play a competitive game of Pin the Tail on the Donkey. He must administer swift discipline in line with the offense. He also knows that there is no one discipline that can be levied against the band members. It must be done on a case-by-case basis. In this case, the two band members were penalized pay for the time spent playing a game when they should have been practicing for their show. 4. Unity of Command: Employees should have only one direct supervisor. Multiple people sometimes give orders. In the case of the rock band, Fayol is in charge. This is expressed by the name of the band and implied by the orderly way in which work is delegated. Fayol is the only person to give direction. 5. Unity of Direction: Teams with the same objective should be working under the direction of one manager and using one plan. This will ensure that action is properly coordinated. Just like unity of command, it is important for Fayol to keep the band on a single track, course or direction. One manager. One plan. One vision. 6. Subordination of Individual Interests to the General Interest: The interests of one employee should not be allowed to become more important than those of the group. This includes managers. Fayol knows how to maintain a balance between personal endeavors and those of the greater good. Fayol and the Principles are a rock band. This is their purpose, their identity. If one of the members feels differently, regardless of how strongly he feels, this self-interest, or individual interest, is not more important than those of the band and its members. 7. Remuneration: Employee satisfaction depends on fair remuneration for everyone. This includes financial and non-financial compensation. When it comes to payday, Fayol knows that he must pay the band and pay them fairly. This includes money and perks. It is tempting to take all of the backstage perks and keep them for himself, like free T-shirts and sodas, but by sharing the rewards, Fayol has a much more satisfied team. Lesson Summary In summary, Fayol’s 14 Principles of Management serve the organization as a whole. By dividing the work into specialized and specific jobs, workers are able to work more efficiently. Small management units who oversee functional areas of the organization are now able to assign work and hold workers accountable for their production. This makes it easier to measure productivity. Once a system of accountability is in place and productivity can be monitored, it is easier to determine who is performing and who is not performing. Managers are able to selectively and individually discipline workers who fall short of goals quickly and in the correct measure. Having just one manager assigned to a team takes away any task confusion. Workers have only one supervisor directing them. With only one supervisor directing work, it is easy to motivate employees to buy into one plan. This minimizes self-interest. With only one manager managing the work of one team, which shares one vision, compe nsating the team can be done fairly.

Landfill Fire Threatens Nuclear Waste Site Outside St. Louis

Later the EPA admitted that people who work at the West Lake Landfill have to be cautious and careful to protect their health. According to Veronica LaCapra’s report, Landfill Fire Threatens Nuclear Waste Site Outside St. Louis. if the Westlake Landfill’s soil is disarranged, â€Å"radioactive dust particles could be released into the atmosphere.† Unfortunately, it may lead to the inhalation of airborne radioactive dust particles. If these particles are inhaled by workers it could seriously harm their health. The EPA suggested that continued monitoring is advised and necessary, due to possible elevated levels of radon in the air at the landfill and the surrounding area. It seems full safety processes must be put into place to reduce harmful dusting to protect everyone from potential exposure during any cleanups. Even though the residents of North St. Louis, the EPA and other authorities have their points of view, further serious claims continue to be revealed. An oppositional statement using government records and the EPA s data was reported by Và ©ronique LaCapra just recently. In the article â€Å"Confused about Bridgeton, West Lake landfills? Here s what you should know,† published on October 20, 2015 on the KWMU s website, states that there were reports about high level of radiation found in residential areas and trees. In addition, a second report was released about the Wilfong family who lives in Bridgeton, MO within smelling distance of the landfill. The family raisedShow MoreRelatedLogical Reasoning189930 Words   |  760 Pagesto two pages, typed, double-spaced. 5. This is an exercise to be done by four students working as a group. The group chooses an issue to debate in front of the rest of the class, but the issue must be approved by the instructor. The group meets outside of class to research the issue. A typical issue might be whether the college should spend more money on athletic scholarships and less money on other projects. Another issue might be whether U.S. defense spending should be cut. Two students agree

Genesis vs. Antigone - Free Essay Example

Sample details Pages: 4 Words: 1245 Downloads: 1 Date added: 2019/05/20 Category Literature Essay Level High school Topics: Antigone Essay Did you like this example? Throughout time, one could see the consistency on what is thought to be the womenrs role in society. As consistent as waves washing upon a shore, society has thought that the womenrs role is to be inferior to the men. The role of a woman is seen clearly in Sophocles Antigone and Genesis, as they both contain a convoluted view of womenrs submission and liberation. Don’t waste time! Our writers will create an original "Genesis vs. Antigone" essay for you Create order Even today, pieces from both works are pulled to argue for or against gender dominance, an argument that has been happening for centuries. Both works of literature portray the womenrs role in society as lesser than the men. In Sophocles Antigone, the main character Antigone; daughter of Oedipus, expresses her desire to stand against Creonrs law; an urge to rebel that was rarely found in ancient societyrs women. In ancient Greece, women were found to be shy, submissive, and passive. On the contrary, men were found to be strong, brave, and dominant. Antigoners bravery and passion represents a rebellion that seems to upset the hierarchy that was ancient Greek society. Her ambition of ignoring Creonrs law and giving her dead brother; Polyneices, a proper burial marks her as a rebel among women, this can be seen when she says He has no business keeping me from what is mine. (Antigone, Line 48), the thought of a man not being able to control a woman. Antigone is willing to risk all for Polyneices honor, this is shown when she says Let me and the ill counsel that derives from me suffer this awful fate; what I shall suffer will be far less dire than dying an ignoble death! (Antigone, Line 95-97). Antigoners honor and willingness to die for what she believes is the right thing to do is what gives her drive to give her brother a proper burial, even if it went against King Creonrs law. On the other hand, Ismene, Antigoners sister is found to be the submissive women that appeals to Creonrs beliefs that women are inferior to men. Her character is the very image of how women are viewed by men in ancient Greece. Her disbelief of Antigoners rebellious ways can be seen when she tries to dissuade Antigone from burying Polyneices. What? You bury him- when a law forbids the city? (Antigone, Line 44), Ismene expressed horror at the very thought of overstepping the womenrs place, as she believed women were weak and men ruled all. This also reveals that she values the menrs laws more than the gods laws. We must remember, first, that we two are by nature women and not fit to fight with men; second, that we are ruled by others stronger then ourselves, (Antigone, Line 61-63). She argues with Antigone throughout the play, attempting to remind her that they are women, and women lack power to defy Creonrs law. Ismene is quite literally the juxtaposition of Antigone, one willing to risk their life for their blood, the other fears authority and death. Ismene being the foil to Antigone, their differences offering perspective to the story. Ancient Greek societyrs belief on what the role of the women is embodied in Ismene. The common belief of the womenrs subordination is seen in King Creonrs character. Creon believes that the men should be the enforcers of the law while women should be weak and easily controlled. His belief that women should never be in control is seen when he speaks to Antigone, Die then, and love the dead if thou must; No woman shall be the master while I live. (Antigone, Lines 524-525). In this quote, Creon shows that his reasoning throughout the play was never based on rationality but, instead, on sexism. Creon expressed his desire to have Antigone mother Thebers next heir; instead, of being put to death, showing that his thoughts were not with the women herself, but with her capabilities to pass on the royal blood. He views women as objects; something to be controlled by men, this can be seen in his conversation with Ismene. When Ismene reminds him of Antigoners engagement to his son Haimon, Creonrs only words were There are other plots of land for him to plow (Antigone, Line 569 ), implying that Antigone is easily replaceable because she is nothing more than an object to please Haimon. Equally important, are the gender roles in Genesis, the role of the women is not too different from Antigone. In the first book of the Bible, God first creates Adam and then he creates Eve. While the order of who was created first would ideally have little effect on the gender roles in society, many see Adam being created first as him being given the position of authority. It is not good that the man should be alone; I will make him a helper fit for him. (Genesis, 2:18), this quote conveys that the role of Eve is to keep Adam company, to help him when he needs it. God made Eve from Adamrs flesh and bone, to some this might mean that she stands as his equal, for Adam was made from God and Eve from Adam. They are all made of the same flesh, therefore, they are all equal. However, Adam was given the privilege to name every animal and to name the woman that would be his wife. This implies that Eve is not equal to her husband, and she does not share the same power as he does. It is not until after Adam and Eve eat the forbidden fruit that the dynamic of roles is somewhat changed. While Adam is punished, he is not made subservient to another being. Eve, on the other hand, is told that she will have the ability to bear children, only she will feel tremendous pain during the birth. In addition, the message given from Genesis on gender roles is noticeable when God informs Eve Your desire shall be for your husband, and he shall rule over you (Genesis, 3:16). The quote quite clearly states the inferior role of the woman and the superiority of the man is expressed in he shall rule over you. In the Book of Genesis, one can easily observe the role of male domination. That said, Chapter One of Genesis view on the role of genders is embodied in Antigoners character; her refusal to follow the social norm, and her desire to honor her fallen brother despite being promised death if done. When God took Adamrs rib to form Eve, he saw they were of the same flesh, therefore, the same social standing. After Chapter One of Genesis, Ismene is found to be embodying the role of genders; her willingness to take orders from men and to follow Creonrs law. Chapter Two and Three of Genesis seems to justify the views of Ismene and Creon, as it conceptualizes the inferiority of women. In conclusion, Sophocles Antigone and the Book of Genesis both contain male dominated gender roles. The womenrs role, in both works of literature, is to be inferior to the men, to serve them, and be controlled by them. Antigone shows the behavior that is expected of all women, and the role they are expected to play in society, while Genesis reveals the moment of women stepping in the supporting role while the man stepped into the lead. Taking all things into consideration, Antigone and Genesis may have started with different ideas of gender roles, but in the end, they both portrayed the lesser social standings of women.