Asian Journal of Nursing Education and Research

Dharitri Swain ¹

Affiliations
1 College of Nursing, All India Institute of Medical Sciences (AIIMS), Sijua, Bhubaneswar, Odisha-751019, IN

Abstract

Background: Globally in all health care systems, major changes have taken place such as: cost effective care, early hospital discharge and high burden of patients with acute and chronic diseases. These escalating changes in health care systems influence quality of care, job satisfaction of nurses and patients perception of care. The aim of the study was to find the relationship between job satisfaction of nursing staff and patients 'perception of the quality of care.

Methods: A co relational study was undertaken among 384 patients and 141 staff nurses in a tertiary teaching hospital Odisha, India within a 3 months period. RHCS questionnaire consists of 42-items was used to measure patients' perception of quality care and KUHJSS consist of 37-items was used to measure job satisfaction of nursing staff. Date was analysed to find out the related factors and relationship between job satisfaction of nursing staff and patients perception of quality care.

Results: Patients' perception of overall quality care positively related to general job satisfaction of nursing staff. The highest job satisfaction levels of quality care were reported by older patients, patients who were in OPD units and patients from rural settings. Also the highest job satisfaction levels were reported by nurses over 51 years of age, nursing leaders, nurses with less than one year or more than 21 years of total work experience, and day shift workers.

Conclusions: Generally job satisfaction of nursing staff is an important aspect for quality care, as evaluated by the patients. It is vital to support the well-being of staff because this has the potential to improve patients' perceptions of quality care.

Keywords

Job Satisfaction, Patient Perception, Quality Nursing Care.

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Dharitri Swain ¹

Affiliations
1 All India Institute of Medical Sciences (AIIMS), Bhubaneswar-751019 Sijua, Dumuduma, Odisha, IN

Abstract

Labour pain is rated as one of the most severe pain which may lead to any risk in any time, so mother should be supported for a joyful birth by relieving maximum level of pain .Water birth used as an alternative therapy for a painless labour . Lying-in warm water for relaxation and pain relief during early labour has been widespread in clinical practice for many decades, but usually for relatively short periods and during early labour. Then, during the 1980s it became increasingly popular to give birth in water using specially designed pools and to use more prolonged immersion in water throughout labour. Labour and birth in water are usually offered to women with an uncomplicated pregnancy at term. Women with a variety of complications, including previous caesarean section, have also used birthing pools for labour and delivery without reported problems. Immersion in water during the first stage of labour is less controversial than immersion either during the second or third stage. All women who labour or give birth in water should have appropriately skilled attendants. Many of the issues listed here are therefore theoretical and further research is required to reliably determine the real effects of labour and birth in water and to guide clinical practice. No randomized trials have compared outcome following birth in water with outcome following conventional birth. Data from the surveillance study provide some reassurance that safety is likely to be comparable. Although only a small proportion of women give birth in water, it is likely that many more use birthing pools during labour. The use of a birthing pool for labour and/or delivery is an option that is now widely offered within maternity units in many parts of the countries and is also available for home births. Women should be provided with balanced information to enable them to make an informed choice about whether and how they use immersion in water. If they use immersion in water, they should be cared for by attendants who have appropriate experience. This article is to provide a review of information on labor and birth in water and to suggest possible strategies to minimize the potential hazards to mothers and infants. It can also be used to promote the maternal and infant benefits, which may arise from choosing this type of birth experience, but are not easily quantifiable. It is written with the belief that clinically sound, evidence based guidelines improve quality of care. They must be evaluated with reference to individual client's needs, resources and limitations unique to the place of birth and variations in client choices.

Keywords

Labour Pain, Water Birth, VBAC, FBM, Prostaglandin.

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Dharitri Swain ¹

Affiliations
1 AIIMS, Bhubaneswar- 751019, Sijua, Dumduma, Odisha, IN

Abstract

The role of the immune system at the implantation site plays important role not rejecting fetus. Over fifty years ago, Sir Peter Medawar proposed the paradigm of why the fetus, as a semi-allograft, is not rejected by the maternal immune system. The presence of the maternal immune system at the implantation site was used as evidence to support this. Medawar's observation was based on the assumption that the placenta is an allograft expressing paternal proteins and, therefore, under normal immunological conditions, should be rejected. It is seen that the placenta is more than a transplanted organ. Based on the data discussed, there may be an active mechanism preventing a maternal immune response against paternal antigens. The trophoblast and the maternal immune system have evolved and established a cooperative status, helping each other for the success of the pregnancy. The differentiation and function of immune cells infiltrating the implantation site depends, largely on the microenvironment created by the placenta. This hypothesis is supported by trophoblast cells is able to induce monocyte-like THP-1 cells to secrete cytokines such as IL-6, IL-8, MCP-1, and GRO-α which has beneficial effects on trophoblast development and function.

The concept that pregnancy is associated with immune suppression has created a myth of pregnancy as a state of immunological weakness and, therefore, of increased susceptibility to infectious diseases. A challenging question is whether the maternal immune system is a friend or a foe of pregnancy. In this review, I discuss data associated to the role of the immune system during pregnancy and clinical implications. A new paradigm in terms of the fetal-maternal immune interaction as well as the immunological response of the mother to microorganism. Here the challenge for midwifery nurses is to better understand the immunology of pregnancy in order to deliver the appropriate treatment to patients with pregnancy complications as well as to evaluate many of the 'classical concepts' to define new approaches for a better understanding of the immunology of pregnancy that will benefit mothers and fetuses in different clinical scenarios. Always Nurse is a unique position to help clients by extending her role through updating new knowledge's and skills in all fields of health care system .So Immunological concept of pregnancy and its clinical implications could be an area of interest for midwifery nurses for clinical practice.

Keywords

IL, NK Cells, Cytokines, Macrophages, Trophoblast.

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