Content uploaded by Sehrish Naz
Author content
All content in this area was uploaded by Sehrish Naz on Apr 10, 2023
Content may be subject to copyright.
JFINPH
BIANNUAL
J Farkhanda Inst Nurs Pub Health
January-June 2021
Vol. 01, No. 01
ISSN: (2788-5704)
JFINPH
BIANNUAL
J Farkhanda Inst Nurs Pub Health
January-June 2021
Vol. 01, No. 01
ISSN: (2788-5704)
Canal Road, University Town
Tel: +92-91-5619671-6
Journal of Farkhanda Institute of Nursing And Public Health (JFINPH) is the official peer-reviewed
research journal of Gandhara University for Nursing and Public Health institute in Peshawar, Pakistan.
The journal provides a platform for original research papers and case reports about health care support,
association, supervision, workforce, programs and exploration procedures of research relevant to
nursing, midwifery, public health and other health-related occupations. JFINPH is the sister journal of
“Journal of Gandhara Medical and Dental Sciences” a HEC-approved journal and is published on
quarterly basis. In this pioneering endeavor, it aims to reinforce and support evidence-based knowledge
and practice by publishing quality research in the form of systematic and other scholarly articles along
with reviews, letters to editor, and case reports.
Publication Cell:
Managing Editor
Gandhara University
Peshawar, Pakistan
+92-91-5711151-3
Fax: +92-91-5844428
Visit Us:
www.jgmds.org.pk
Email:
JFINPH
J Farkhanda Inst Nurs Pub Health
Vol. 01, No. 01
January-June 2021
editor.jfinph@gandhara.edu.pk
sofia.kabir@gandhara.edu.pk
ISSN: (2788-5704)
Journal of Farkhanda Institute of Nursing and Public Health
Samir Khan Kabir
Um - E - Laila
Jafaryad Hussain
Zainab Waheed
CHIEF PATRON
Roeeda Kabir
PATRON
Ejaz Hassan Khan
MANAGING EDITOR
Sofia Shehzad
ASSOCIATE EDITORS
EDITORIAL BOARD
Tezeen Saeed Ali
Najma Naz
Lubna Ghanzal
Sabiha Khanum
Salma Ratani
Afsha Awal Khan
ADVISORY BOARD
Nazia Shoaib Ich (Int)
Ahtisham Younas (Int)
Parveen Ali (Int)
Jehanzeb Khan (Int)
Amynah Mevawala
STATISTICIAN
Hamid Hussain
BIBLIOGRAPHER
Sher Bahadar
Dildar Muhammad
CHIEF EDITOR
JFINPH
J Farkhanda Inst Nurs Pub Health
Vol.01, No.01
January-June 2021
ISSN: (2788-5704)
8-11
12-16
1-2
3-7
CONTENTS
CONTENTSCONTENTS
JFINPH
17-21
22-26
J Farkhanda Inst Nurs Pub Health
Vol.01, No.01
January-June 2021
ISSN: (2788-5704)
COVID-19; Vaccine Administration and the Role of Nurses/Midwives Dildar Muhammad
Assessment of Symptom and Quality of Life i n Pediatric Brain
Tumor Survivors
Nusrat Noreen
Rashida Manzoor
Roheeda Amanullah
Naeema Sher Akbar
Nazeer Ali Buriro
Effectiveness of Problem Based Learning Versus Lecture
Method among Nursing Students, Peshawar
Sameena Naz
Bakhtiyar Ali Shah
Akhter Zeb
Factors Contributing to Burnout among Nurses Working in
Emergency Rooms
Fouzia Jameel
Samina Kousar
Nadia Saif
Mansoor Ghani
Shahjahan
Waqas Latif
Perception of Student Nurses Regarding Characteristics of an
Effective Clinical Instructor: A Cross-Sectional Study
Amanullah Khan
Nishat Begum
Sehrish Naz
Parents Satisfaction Regarding their Child with Nursing Care in
Tertiary Care Hospitals in Peshawar District, KPK
Muhammad Anwar
-ul-
Shakeel Ahmed
Abdullah
Shaida Khan
Obaid Haq
EDITORIAL
1
January-June 2021
JFINPH
J Farkhanda Inst Nurs Pub Health
COVID-19; VACCINE ADMINISTRATION AND THE ROLE OF NURSES/ MIDWIVES
Dildar Muhammad
Assistant Professor Nursing
KMU Institute of Nursing Sciences, Peshawar
The COVID-19 vaccine is finally available in the market and across the globe its public administration
has started widely. Safe and effective administration of COVID-19 vaccine is the primary responsibility
of nurses, midwives and other healthcare professionals1. Therefore, nurses and other professionals
who are involved in administering vaccines must be knowledgeable, confident and competent. Nurses
have main role in the administration of the COVID-19 vaccine therefore it is compulsory that nurses
possess accurate knowledge and skills to administer vaccines2. Core competencies required of nurses
include product knowledge, storage and handling, administration and documentation3.
Before administering vaccine training is required. Depending on the product nurses must have
knowledge of the eligibility requirements, vaccination schedule and history, contraindications,
precautions and clinical considerations4. Moreover, it is important to understand recommended
observation time and signs and symptoms of allergic reactions and anaphylactic shock (if any). Safe
administration also requires that nurses must possess accurate knowledge of storage and handling of
COVID-19 vaccine including inspecting, unpacking, accounting, and storing vaccines5. Depending on
the product, nurses must demonstrate the knowledge of maintaining cold chain and any protocol in
case of cold chain failure. Proper monitoring of temperature and recording it are vital for safe and
effective administration of COVID-19 vaccine.
Administration of vaccine is the key competency required of nurses that include infection prevention
and control as well as mitigation measures. Identifying proper needle gauge and length is important in
addition to best injection site based on route, age and health of the recipient6,7. Correct intramuscular
injection technique is the cornerstone to prevent administration errors such as shoulder injury etc.
Similarly, nurses should have the knowledge as per standard protocol of how to dispose vials,
syringes, needles and other supplies8. Finally, proper documentation of vaccination is key in
appropriate data systems. Evidence suggest that health care professionals including nurses and
midwives are highly trusted when it comes to vaccine information therefore it is vital that nurses
provide appropriate information including vaccination report card to vaccine recipient. Nurses should
also be able to explain to the patient any adverse effect and what to do in such situations.
For the safe and effective administration of vaccine, it is important that nurses must self-assess
themselves in the above areas and where required must improve themselves before embarking on to
administer COVID-19 vaccines to public. Facilities and vaccine centers must arrange training and
refresher courses for nurses and support staff involved in administration of vaccines.
REFERENCES:
1. Dror AA, Eisenbach N, Taiber S, Morozov NG, Mizrachi M, Zigron A, et al. Vaccine hesitancy:
the next challenge in the fight against COVID-19. Euro J Epidemiol. 2020;35(8):775-9.
2. Berman AJ, Snyder S, Frandsen G. Kozier and Erb's Fundamentals of Nursing. 11th ed.
Australia: Pearson; 2020.
2
EDITORIAL
January-June 2021
JFINPH
J Farkhanda Inst Nurs Pub Health
3. Centre of Disease Control. COVID-19 vaccine administration competencies Assessment
Form. 2021. Available from: https://www.cdc.gov/vaccines/covid-19/downloads/competencies-
screening-checklist.pdf
4. Thomas KS. Intramuscular injections for COVID-19 vaccinations. J Nucl Med Technol.
2021;49(1):11-12.
5. Mills MC, Salisbury D. The challenges of distributing COVID-19 vaccinations. Eclinical Med.
2021;31(100674):1-2.
6. Le TT, Andreadakis Z, Kumar A, Román RG, Tollefsen S, Saville M, et al. The COVID-19
vaccine development landscape. Nat Rev Drug Discov. 2020;19(5):305-6.
7. Picchio CA, Carrasco MG, Sagué-Vilavella M, Rius C. Knowledge, attitudes and beliefs about
vaccination in primary healthcare workers involved in the administration of systematic
childhood vaccines, Barcelona, 2016/17. Euro Surveill. 2019;24(6):1800117.
8. Murphy K. Administration of the flu vaccination: required skills and knowledge. Br J Nurs.
2020;29(20):1168-71.
3
JFINPH
J Farkhanda Inst Nurs Pub Health
ASSESSMENT OF SYMPTOM AND QUALITY OF LIFE IN PEDIATRIC BRAIN
TUMOR SURVIVORS
Nusrat Noreen1, Rashida Manzoor2
, Nazeer Ali Buriro3, Roheeda Amanullah4, Naeema Sher Akbar5
ABSTRACT:
OBJECTIVES:
The purpose of this study was to assess the relationship between quality of life and demographic
variables in pediatric brain tumor survivors.
METHODOLOGY:
A descriptive cross-sectional study was conducted in two tertiary care hospitals of Peshawar, Khyber
Pakhtunkhwa. Census method (consecutive) sampling technique was used to collect data from 100
participants using quality of life checklist and symptoms memorial assessment scale.
RESULTS:
The mean age of the participants was 8.71 years. Almost all participants reported symptoms such
as: headache, nausea and vomiting, social life restrain, poor schooling, difficulty urination and
concentration, poor attention, lack of energy, cough, feeling sadness and nervousness, dry mouth,
numbness, difficulty in sleeping, diarrhea, shortness of breath, sweating and itching. Ove rall,
majority (53%) participants had average quality of life, 35% participants had good quality of life, and
only 12% participants of the study had poor quality of life.
CONCLUSION:
Pediatric brain tumor survivor patients experienced variety of symptoms. The quality of life among
pediatric brain tumor survivor patients was not very bad, as they have reported average quality of life
in this study.
KEYWORDS: Pediatric, Brain Tumor, Survivors, Quality of Life, Symptoms Experiences.
INTRODUCTION:
Cancer is the major health problem
January-June 2021
1
worldwide and the second leading cause of
death in United States (US) . It was reported
countries but also approximately 70% of
deaths are reported due to cancer in low-
income and middle-income countries1,3.
Pediatric cancers are life threatening and the
condition is distressing to the children and
their families at diagnosis, both during
treatment and beyond4. Cancer is the leading
cause of death in children more than one
in 2018 that 1,735,350 new cases and
609,640 deaths were believed to have
resulted by cancer in United States2. It is not
only the major health problem in developed
How to cite this article:
Noreen N, Manzoor R, Buriro NA, Amanullah R, Akbar NS. Assessment of Symptom and Quality of Life in Pediatric Brain
J Farkhanda Inst Nurs Pub Health. 2021; 1(1):
3-7
Correspondence
1Nusrat Noreen, Nursing Instructor, Lady Reading
Nursing College, Peshawar.
Cell: +92-300-5969002
Email: nusratnoren@gmail.com
2Nursing Instructor, Post Graduate Nursing College,
Peshawar
3Associate Professor, Shaheed Benazir Nursing
, College Shaheed Benazir Bhutto University, Sindh.
Tumor Survivors.
month of age. In the last 10 years cancer
4Nursing instructor, School of Nursing, Hayatabad
5Staff Nurse, Jabir Al Ahmad Al Sabah Hospital, Kuwait
Medical Complex, Peshawar
4
JFINPH
J Farkhanda Inst Nurs Pub Health
METHODOLOGY:
A descriptive cross-sectional study was
conducted in two tertiary care hospitals of
Peshawar, Khyber Pakhtunkhwa, namely,
Lady Reading Hospital (LRH) and Hayatabad
Medical Complex (HMC). Total of 100
pediatric brain tumor survivors were included
in the study using consecutive sampling
technique. Data were collected in
Neurosurgical oncology unit and OPDs of the
hospitals. The study was carried out from
June 2019 to November 2019.
Children from birth to 18 years of age who
had completed their active treatment like
surgery, systemic or radiation therapy for the
brain tumor participated in the study. While
children undergoing palliative treatment,
patients undergoing active treatment or
investigation for a secondary malignancy or
disease relapse were excluded from the
study. Data were collected using paediatric
quality scale (PedQL) scale to measure the
quality of life of participants and Memorial
Symptom Assessment Scale (MSAS) to
identify the symptoms among brain tumour
survivors. The participants who secure more
than 75% marks according to the quality of
life scale were considered having poor quality
of life; the marks between 50%-75% were
considered as average quality of life; and
marks less than 50% were good quality of
life.The data were collected after approval
from ASRB and ethical review board. Written
consent was taken from the patients before
collecting the data. Permission was also
sought from the Directors of both hospitals.
Data were analyzed statistically through
SPSS version 24.
ASSESSMENT OF SYMPTOM AND QUALITY OF LIFE
January-June 2021
Brain cancers add more to cancer statistics.
The incidents of brain cancers increase in the
early age (children) and decrease with the
age7. In developing countries i.e. Pakistan
and India, the mortality rate of pediatric brain
cancer is substantially high. In Pakistan, 6.1
to 9.3 cases per 1000,000 children age
between 0-14 years are diagnosed with brain
tumor and out of them 90% brain tumor
victims die8, 9. It is evident from the literature
that behavior and dietary habits are risk
factors, which lead to around one third of
cancer deaths10. The severity of brain cancer
depends on the type, grade and location of
brain cancer. Grade 1 is the least serious and
grade 4 is the most serious and danger stage
of cancer. Over 70% of children with a
primary central nervous system tumor used
to live for 5 to 10 years following diagnosis,
many cured from their disease2, 11. The
survival of pediatric brain tumors patients
depends on the grade and location of
tumor12. Brain tumor in children appears with
certain symptoms in which headache,
enlarge head, nausea and vomiting,
personality changes, irritability, drowsiness,
seizures and coma are common. According
to literature, the most common symptom that
appears first is headache (41%), vomiting is
estimated in 12% patients, visual difficulties,
educational and behavioral problems
reported in 10% brain cancer patients13.
Among treatment options, the most common
management is chemotherapy, the second
one is the surgical removal of tumor and the
third one is radiation therapy14. Surgical
removal of tumor has also some severe
complications in which infections, sepsis and
regrowth of tumor are common15. Brain
cancer badly impacts the children social,
emotional, physical, psychosocial status, and
quality of life. According to one study,
children with brain tumors have lower health
related quality of life (HRQL) than other
children with cancer. Hearing loss, learning
problems and balance difficulties are the
main issues among these children16. There is
a need of exploring the hidden issue and
identify prevalence, severity and problems
associated with brain tumor and their effect
on quality of life.
incidents are almost static in females but the
incident rate is declined by 02% in males5,6
5
JFINPH
J Farkhanda Inst Nurs Pub Health
RESULTS:
Table i: Socio-Demographic Profile of the
Participants (n=100)
Frequency Percent
Age
Less than 5 Years 24.0 24.0
5-10 Years 42.0 42.0
More than 10 Years 34.0 34.0
Total 100 100.0
Type of Cancer
Benign Cancer 55.0 55.0
Malignant Cancer 45.0 45.0
Total 100 100.0
Gender
Male 35.0 35.0
Female 65.0 65.0
Total 100 100.0
Treatment Option
Surgery 51.0 51.0
Chemotherapy 39.0 39.0
Radiotherapy 10.0 10.0
Total 100 100.0
Tumor Location
Supratentorium 66 66.0
Intratentorium 34 34.0
Total 100 100.0
Tumor Grade
Grade 1 30 30.0
Grade 2 48 48.0
Grade 3 22 22.0
Total 100 100.0
Ventriculoperitoneal Shunt
Yes 40 40.0
No 60 60.0
Total 100 100.0
Table ii: Symptoms Assessment among Brain Tumor
Survivors
Symptoms
%
Yes
73%
No
27%
Yes
86%
No
14%
Yes
84%
No
16%
Yes
96%
No
4%
Pain, difficulty urination,
Yes
92%
No
8%
Yes
90%
No
10%
Lack of energy, feeling sadness
Difficulty in concentration, poor
attention,
Headache, Cough, vomiting, nausea,
Dry Mouth, Diarrhea, Shortness of
breath
Nervousness, difficulty in sleeping,
Poor schooling, social life restraints
Figure 1: Quality Of Life Of Brain Tumor Patients
DISCUSSION:
A study revealed lack of energy (49.7%) and
(6.3%) problem in urination19. Feeling of
nervousness, worry, irritability, and sadness
were reported in 35% participants. Pain,
drowsiness, nausea and vomiting, cough,
and lack of appetite were reported in half
(50%) participants14,17,18. Similarly, another
study revealed that around 60% children with
brain tumor experiences similar symptoms
depend on the severity and condition of the
patients20. More than half of the survivors
(64%) reported lack of concentration, lack of
sleep, headache, lack of energy and pain13.
These studies findings are coherent to our
study result. In addition, another study
reported most common symptoms with
occurrence >40% were lack of energy, lack of
ASSESSMENT OF SYMPTOM AND QUALITY OF LIFE
January-June 2021
6
JFINPH
J Farkhanda Inst Nurs Pub Health
appetite, feeling drowsy, sweating, worrying,
nausea, dry mouth, pain, and lack of
concentration. All these symptoms were
frequent, severe and were distressing for the
patients21. There is need to improve health
related quality of life among children with
brain tumor. Feeling of nervousness was
reported among the participants of this study
which is common in other parts of the world
as well. The study present similar findings
regarding worrying about disease process
with other various studies globally22. In the
present study, majority (53%) participants
had average quality of life, 35% participants
had good while only 12% participants of the
study had poor quality of life. No association
was found between quality of life and socio-
demographic variables in the present study.
Most of the symptoms causing poor quality of
life, which is depicted from all the studies
quality of life, were reported strongly
associated (p=0.001) with grading of tumor
among the survivors21. Similarly, another
study reported lower quality of life among
pediatric brain tumor survivors. Likewise, the
study conducted by Huda Abu-Saad Huijer,
Knar Sagherian and Hani Tamim in Lebanon
revealed good quality of life among pediatric
brain tumor survival. Physiological support
was reported as an important factor
associated with good quality of life22. A study
by Gadiraju Padmaja also supports these
results23. Though variation exists in the
findings of the studies but all indicate that
pediatric brain tumor patients need proper
social support, symptomatic treatment,
psychological support and education to
improve their quality of life13.
CONCLUSION:
Pediatric brain tumor survivor patients
experienced variety of symptoms but poor
sleeping, lack of appetite, lack of
concentration, lack of energy, sadness, and
urination problem affect their daily life
activities, schooling and their overall health.
Ultimately, these factors affect the quality of
life of patients. Pediatric brain tumor survivor
patients have average quality of life across
the globe. Symptomatic treatment, coping
strategies, educational trainings and
psychological support are recommended to
improve their quality of life.
LIMITATIONS:
The study design is cross sectional so the
generalization may not be applicable for all
pediatric brain survivors. Future study can be
conducted to evaluate the health education
approach to improve symptoms among brain
tumor survivors.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES:
ASSESSMENT OF SYMPTOM AND QUALITY OF LIFE
January-June 2021
1. Torre LA, Siegel RL, Ward EM, Jemal
A. Global cancer incidence and
mortality rates and trends-an update.
Cancer Epidemiol Biomarkers Prev.
2016;25(1):16-27.
2. Yabroff KR, Lund J, Kepka D,
Mariotto A. Economic burden of
cancer in the US: estimates,
projections, and future research.
Cancer Epidemiol Biomarkers Prev.
2014;11(301):1-18.
3. Pace A, Villani V, Di Lorenzo C,
Guariglia L, Maschio M, Pompili A, et
al. Epilepsy in the end-of-life phase in
patients with high-grade gliomas. J
Neuro-Oncol. 2013;111 (1):83-6.
4. Zhang K, Jian-bo S. A new method
for asynchronous multisensor
information fusion: 27th Annual
German Conference on AI.
2004;70(2):410-23.
5. Siegel RL, Miller KD, Jemal A. Cancer
Statistics, 2017. Cancer J Clin.
2017;67(1):7-30.
6. Ellison LF, De P, Mery LS, Grundy
PE. Canadian cancer statistics at a
glance: cancer in children. CMAJ.
2009;180(4):422-4.
7. Langer CE, Turner MC, Mckean-
cowdin R, James L. Childhood brain
tumor epidemiology: a brain tumor
epidemiology consortium review.
Cancer Epidemiol Biomarkers Prev.
2015;23(12):2716-36.
8. Badar F, Mahmood S. Epidemiology
of cancers in Lahore, Pakistan,
among children, adolescents and
adults, 2010-2012: a cross-sectional
study part 2. BMJ Open.
2017;7(12):1-15.
7
JFINPH
J Farkhanda Inst Nurs Pub Health
ASSESSMENT OF SYMPTOM AND QUALITY OF LIFE
January-June 2021
1. Nusrat Noreen - Concept & Design; Data Acquisition; Data Analysis/ Interpretation;
Critical Revision; Drafting Manuscript; Supervision; Final Approval
2. Rashida Bibi - Drafting Manuscript
3. Nazeer Ali Buriro - Critical Revision
4. Roheeda Amanullah - Data Acquisition; Drafting Manuscript
5. Naeema Sher Akbar - Supervision; Critical Revision
9. Gupta S, Morris SK, Suraweera W,
Aleksandrowicz L, Dikshit R, Jha P.
(2016). Childhood cancer mortality in
India: direct estimates from a
nationally representative survey of
childhood deaths. J Global Oncol.
2016;2(6):403-11.
10. Wilne SH, Dineen RA, Dommett RM,
Chu TPC, Walker DA. Identifying
brain tumours in children and young
adults. BMJ. 2013;347(7928):1-10.
11. McKinney PA. Brain tumours:
incidence, survival, and aetiology. J
Neurol Neurosurg Psychiatry.
2004;75(suppl_2):ii12–ii17.
12. Hummel TR, Chow LM, Fouladi M,
Franz D. Pharmacotherapeutic
management of pediatric gliomas:
current and upcoming strategies.
Pediatr Drugs. 2013;15(1):29-42.
13. Hockenberry M. Symptoms
management research in children with
cancer. J Pediatr Oncol Nurs.
2011;21(3):132-6.
14. Ruland CM, Hamilton GA, Schjodt-
Osmo B. The complexity of symptoms
and problems experienced in children
with cancer: a review of the literature.
J Pain Symptom Manage.
2009;37(3):403-18.
15. Yeh CH, Wang CH, Chiang YC, Lin L,
Chien LC. Assessment of symptoms
reported by 10-to 18-year-old cancer
patients in Taiwan. J Pain Symptom
Manage. 2009;38(5):738-46.
16. Campbell C, Greenfield JP. Precision
oncogenomics in pediatrics: a
personal reflection. Mol Case Stud.
2018;4(2):a002865.
17. Macartney G, Harrison MB,
VanDenKerkhof E, Stacey D,
McCarthy P. Quality of life and
symptoms in pediatric brain tumor
survivors: a systematic review. J
Pediatr Oncol Nurs. 2014;31(2):65-
77.
18. Ewing JE, King MT, Smith NF.
Validation of modified forms of the
PedsQL generic core scales and
cancer module scales for adolescents
and young adults (AYA) with cancer
or a blood disorder. Qual Life Res.
2009;18(2):231-44.
19. MacArtney G, Vandenkerkhof E,
Harrison MB, Stacey D. Symptom
experience and quality of life in
pediatric brain tumor survivors: a
cross-sectional study. J Pain
Symptom Manage. 2014;48(5):957-
67.
20. Bell KR, O’Dell MW, Barr K, Yablon
SA. Rehabilitation of the patient with
brain tumor. Arch Phys Med Rehabil.
2007;79(3 SUPPL. 1):37-47.
21. Pakdaman A. Symptomatic treatment
of brain tumor patients with sodium
selenite, oxygen and other supportive
measures. Biol Trace Elem Res.
2011;62(1–2):1-6.
22. Abu-Saad Huijer H, Sagherian K,
Tamim H. (2013). Quality of life and
symptom prevalence as reported by
children with cancer in Lebanon. Eur
J Oncol Nurs. 2013;17(6):704-10.
23. Barre PV, Padmaja G, Rana S,
Tiamongla. Stress and quality of life in
cancer patients: medical and
psychological intervention. Indian J
Psychol Med. 2018;40:232-8.
CONTRIBUTORS
8
J Farkhanda Inst Nurs Pub Health
January-June 2021
JFINPH
EFFECTIVENESS OF PROBLEM BASED LEARNING VERSUS LECTURE METHOD
AMONG NURSING STUDENTS, PESHAWAR
ABSTRACT:
OBJECTIVES:
The objective of the study was to determine the effectiveness of problem-based learning (PBL)
versus lecture-based learning (LBL) among nursing students of Public Sector Nursing Colleges.
METHODOLOGY:
A quasi-experimental study was carried out in Public Sector Nursing Colleges. Overall, 69 students
of 2nd semester were included in the study. Initially, data were collected using a predesigned
questionnaire. Students were randomly divided into two groups; one group were subjected to the
Lecture based learning while other group were subjected to Problem based Learning. Learning
objective was the same for both groups. The topics was given 5 days before the test to the
students. Test was taken from both the groups. Their scores on each topic was recorded in SPSS
23.0.
RESULTS:
There was no significant difference among the participants demographic variables. The test results
showed students’ performance was high in problem-based learning in comparison to lecture based
learning methods (P<0.001).
CONCLUSION:
Students performance in PBL were higher which indicates that PBL is effective as compared to
LBL.
KEYWORDS: Problem Based Learning, Education, Lecture, Teaching, Learning
Sameena Naz1, Bakhtiyar Ali Shah 2, Akhter Zeb3
How to cite this article:
Naz S, Shah BA, Zeb A. Effectiveness of Problem Base Learning versus Lecture Method among Nursing
Peshawar
Correspondence
, Govt College of
1
2
3
Sameena Naz, Nursing Instructor
Nursing, LRH, Peshawar
Cell: +92 -342-8456448
saminanaz069@gmail.comEmail:
Lecturer, Institute of Nursing KMU, Peshawar
Principal, Ismail Nursing Institute, Swat
I
NTRODUCTION:
1. Teaching and learning
life; it is comprised of two unified processes of
teaching and learning
Education is the vital source for a successful
8-11
J Farkhanda Inst Nurs Pub Health. 2021; 1(1):
go side by side in educational organizations
since the origin of education2. Changes in the
process of education occur over time.
Problem-based learning (PBL) started in 1962
and became popular in all fields of education,
especially in the field of Medical education3.
Problem-based learning has achieved a high
level of learning strategy across the globe and
is used in several countries with high
successes in the field of medicine, nursing
and social science4. It is a process of solving
the problem in a given scenario, which gives
presents new strategies to solve it5. Finding
stimulus to the learner about the problem and
Students,
9
JFINPH
J Farkhanda Inst Nurs Pub Health
LBL method in nursing education of two
METHODOLOGY:
A quasi-experimental study was used to
determine the effectiveness of problem-based
learning (PBL) vs. Lecture-based learning
(LBL) in nursing education. It was conducted in
two public institutes of nursing in Peshawar,
i.e. Institute of Nursing Sciences and the
Postgraduate College of Nursing Hayatabad.
A total 69 nursing students of 2nd semester
were included in the study. One group was
subjected to the lecture-based learning and the
other group was subjected to problem-based
learning method. Results are displayed in
graphs, tables, with a brief description.
Learning objective was the same for both
groups. The topics was given 5 days before
the test to the students. Test was taken from
both the groups. Their scores on each topic
was recorded in SPSS 23.0. Frequencies of
variables in both groups were measured. A
Chi-square test was applied to assess
statistical significance.
RESULTS:
A total of 69 participants were recruited from
two public sector nursing colleges of
Peshawar. Both males and females were
included in the study. 84% were females and
16% were males.
public institutes. The result will help to
improve the teaching and learning
methodologies.
Table i: Comparison of Problem-based learning
vs Lecture Based Learning
Topics for the
students
Performance of
students
Lecture
Method
PBL
Method
Total
Chi-
Square
Level
of Sig
sketch the
pathway of gate
control theory
Poor
13
09
22
27.22
<0.05
Fair
09
26
34
Good
11
11
Excellent
01
01
Differentiate
Between Acute
and Chronic
Pain
Poor
17
19
36
5.67
<0.05
Fair
04
14
18
Good
01
10
11
Excellent
0
04
04
Identify Factors
that Aggravate
Pain
Poor
12
04
16
3.37
<0.05
Fair
10
32
42
Good
-
-
-
11
11
one knows how to apply it in real-life
situations13. Most of the participant were
female, which is like a study conducted in the
DISCUSSION:
Possessing knowledge is not sufficient unless
EFFECTIVENESS OF PROBLEM BASE LEARNING
January-June 2021
determine the effectiveness of the PBL versus
from study conducted in the University of
California shows that PBL gives more
opportunities for clinical skill applications6.
One study highlighted students preferred
problem-based learning over lecture-based
learning because it enhances motivation,
gives a higher quality of education, with other
advantages like better knowledge
maintenance, class attractiveness, and
practical use7. Moreover, students in PBL
develop higher-order thinking and positive
effect on their decision-making ability and
establish greater satisfaction than students‘ in
LBL. A Chinese study reveals that PBL is
increasingly popular among preventive
medicine8. Overall, PBL was associated with
a significant increase in students' theoretical
examination scores along with problem-
solving skills, self-directed learning skills, and
collaborative skills than LBL8. Results
Chicago indicated that the level of knowledge
in the PBL group was significantly higher than
Lecture group9. Students‘ motivation was
drastically higher in the PBL group and had
higher motivation toward learning as
compared to the lecture group10. In students‘
view, PBL was effective in increasing
students‘ ability to integrate theory and
practice in clinical practice11. In Pakistan
majority of the educational institutes follow the
traditional methods such as lecture and other
strategies for teaching which leads to rot
learning12. The present study aimed to
10
JFINPH
J Farkhanda Inst Nurs Pub Health
USA14. Concerning the effectiveness of the
PBL experience, it was found that PBL
allowed the students to learn on their own.
Results of this study indicated that students
learn more effectively through PBL as
compared to the lecture method. A similar
study carried out in Iran showed that PBL is
highly preferred over LBL9. In Egypt15 the
results showed significant difference in PBL
and LBL methods. A study conducted in
Pakistan16 to compare the medical student‘s
performance in problem-based learning and
lecture-based learning methods. The results
showed that in comparison to lecture-based
learning, the problem-based learning was
more effective. A study reported that
educational intervention improves the nursing
critical thinking skills which help them to take
health care management decisions
effectively10,17. In our study, most of the
students PBL scores were fair and good as
compared to scores in LBL which were below
the fair. The findings were consistent with
other studies14,18.
CONCLUSION:
Students in PBL gained more knowledge
shown by their higher scores, which
indicates that PBL was effective as
compared to LBL.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES:
1. Latham L. Concept-Based
Education. In: Staat DW, editor.
Student-Focused Learning: Higher
Education in an Exponential Digital
Era. Maryland, USA: Rowman &
Littlefield; 2020. 1-18 p.
2. Demirel M, Dağyar M. Effects of
problem-based learning on attitude: a
meta analysis study. Eurasia J Math
Sci Technol Educ. 2016;12(8):2115-
37.
(1):2018;
3. He Y, Du X, Toft E, Zhang X, Qu B,
Shi J, et al. A comparison between
the effectiveness of PBL and LBL on
improving problem-solving abilities of
medical students using
questioning. Innovations Educ Teach
Int. 55 44-54.
4. Ma Y, Lu X. The effectiveness of
problem-based learning in pediatric
medical education in China: a meta-
analysis of randomized controlled
trials. Medicine. 2019;98(2).
5. Salari M, Roozbehi A, Zarifi A,
Tarmizi RA. Pure PBL, Hybrid PBL
and Lecturing: which one is more
effective in developing cognitive skills
of undergraduate students in pediatric
nursing course?. BMC Med Educ.
2018;18(1):1-15.
6. Yun B, Su Q, Cai YT, Chen L, Qu CR,
Han L. The effectiveness of different
teaching methods on medical or
nursing students: protocol for a
systematic review and network meta-
analysis. Medicine. 2020;99(40).
7. Blakeslee JR. Effects of high-fidelity
simulation on the critical thinking skills
of baccalaureate nursing students: a
causal-comparative research
study. Nurse Educ Today.
2020;92:104494.
8. Seibert SA. Problem-based learning:
a strategy to foster generation Z's
critical thinking and
perseverance. Teach Learn Nurs.
2021;16(1):85-8.
9. Chernikova O, Heitzmann N, Stadler
M, Holzberger D, Seidel T, Fischer F.
Simulation-based learning in higher
education: a meta-analysis. Rev Educ
Res. 2020;90(4):499-541.
10. López M, Jiménez JM, Martín-Gil B,
Fernández-Castro M, Cao MJ, Frutos
M, et al. The impact of an educational
intervention on nursing students'
critical thinking skills: a quasi-
experimental study. Nurse Educ
Today. 2020;85:104305.
11. Zaidi U, Hammad LF, Awad SS,
Qasem HD, Al-Mahdi NA. Problem-
based learning vs. traditional teaching
methods: self-efficacy and academic
performance among students of
Health and Rehabilitation Sciences
College, PNU. Rehabilitation.
2017;55:38-5.
12. McKnight K, O'Malley K, Ruzic R,
Horsley MK, Franey JJ, Bassett K.
Teaching in a digital age: how
educators use technology to improve
student learning. J Res Technol Educ.
2016;48(3):194-211.
EFFECTIVENESS OF PROBLEM BASE LEARNING
January-June 2021
11
JFINPH
J Farkhanda Inst Nurs Pub Health
13. Martins AD, Pinho DL.
Interprofessional simulation effects for
healthcare students: a systematic
review and meta-analysis. Nurse
Educ Today. 2020;104568.
14. Kang J, Song J, Noh W. A systematic
review and meta-analysis of the
effects of global health competency
improvement programs on nurses and
nursing students. J Adv Nurs.
2020;76(7):1552-66.
15. Thabet M, Taha EE, Abood SA,
Morsy S. The effect of problem-based
learning on nursing students‘ decision
making skills and styles. J Nurs Educ
Pract. 2017;7(6):108-16.
16. Faisal, R., Khalil-ur-Rehman, B. S., &
Shinwari, L. (2016). Problem-based
learning in comparison with Lecture-
based learning among medical
students. J Pak Med Assoc, 66(6),
650-653.
17. Tang, S., Long, M., Tong, F., Wang,
Z., Zhang, H., & Sutton-Jones, K. L.
(2020). A Comparative Study of
Problem-Based Learning and
Traditional Approaches in College
English Classrooms: Analyzing
Pedagogical Behaviors Via
Classroom Observation. Behavioral
Sciences, 10(6), 105.
18. Yue, M., Zhang, M., Zhang, C., & Jin,
C. (2017). The effectiveness of
concept mapping on development of
critical thinking in nursing education:
A systematic review and meta-
analysis. Nurse education today, 52,
87-94.
EFFECTIVENESS OF PROBLEM BASE LEARNING
January-June 2021
CONTRIBUTORS
Data Analysis/Interpretation
1. Sameena Naz - Concept & Design; Data Acquisition; Drafting Manuscript; Criti cal Revision;
2. Bakhtiyar Ali Shah - Concept & Design; Data Analysis/Interpretation; Supervision
3. Akhter Zeb - Data Acquisition;
12
JFINPH
J Farkhanda Inst Nurs Pub Health
FACTORS CONTRIBUTING TO BURNOUT AMONG NURSES WORKING IN
EMERGENCY ROOMS
Fouzia Jameel1, Samina Kousar2, Nadia Saif3, Mansoor Ghani4, Shahjahan5, Waqas Latif6
ABSTRACT:
OBJECTIVES:
To assess the burnout among nurses working in emergency rooms of public sector hospitals and
contributing factors to burnout among them.
METHODOLOGY:
The study included nurses (N=130) having experience of two or more years in emergency rooms,
in public sector hospitals of Rawalpindi/Islamabad and Lahore. Data was collected with the help of
a self-structured questionnaire. Questionnaire was validated by sample pilot study of 20 nurses
and with consultancy of statistician.
RESULTS:
The study revealed that out of 130 participant nurses, 126 (92.92%) were found to be suffering
from burnout. Among them 86 (66.15%) had mild burnout and 40 (30.76%) were with moderate
burnout. Among contributory factors of burnout, work related burnout was significantly higher as
compared to personal and client related burnout.
CONCLUSION:
Nurses working in emergency rooms showed positive results of having burnout especially work
related.
KEYWORDS: Nurse, Burnout, Emergency Room (ER), Stress, Duties
Mianwali..
Email: fouziajameel1984@gmail.com
HOD, UHS Institute of Nursing
Assisstant Professor, Akhtar Saeed Medical & Dental
College, Lahore
Coordinator MSC Program UHS, Lahore
Library Assistant, UHS Lahore
BioStatisticain, UHS, Lahore
Correspondence
Fouzia Jameel, Nursing Instructor, CON DHQ
Cell: +92 307-5583612-
, Lahore.
.
1
2
3
4
5
6
extensive commitment, time, and energy
regarding patient care, management, and
service deliveries. The unpredictable working
conditions by managing critical patients with
different diseases, injuries, psychological
conditions often lead to burnout1. It is
characterized by depletion of energies,
disappointment, doubts, depersonalization,
and frustration leading to loss of purpose,
ideas, and energy2. The person may develop
INTRODUCTION:
Nursing is a demanding career that involves
symptoms of stress including backaches,
indigestion, and lower resistance. Burnout also
leads to low morale, family difficulties and
social problems3. Fatigue, headaches,
irritability, eating issues, insomnia, emotional
January-June 2021
How to cite this article:
Jameel F, Kousar S, Saif N, Ghani M, Shahjahan, Latif W. Factors Contributing to Burnout among Nurses Working in
Emergency Rooms. J Farkhanda Inst Nurs Pub Health. 2021; 1(1): 12-16
13
JFINPH
J Farkhanda Inst Nurs Pub Health
unpredictability and inflexibility and relation
Lahore, Punjab, Pakistan. The questionnaire
with individuals are some prominent clinical
symptoms4. High levels of burnout can
negatively affect patients’ satisfaction, work
environment and also have an adverse
influence on the performance of the
individuals5,6. Burnout also disturbs the life
quality of employees with higher interpersonal
conflicts and antagonism leading to excessive
absenteeism; high turnover rate and increase
in health care cost7. The factors related to
burnout have three dimensions including
socio-demographic factors, work-related
factors, and personal risk factors. Personal
characteristics like hardiness, coping
strategies, and social support can mitigate the
burnout. Stress and burnout are somehow
related to each other. Acute emotive response
and relational stressors occurring at
profession can cause it9. Nurses performing in
the emergency rooms provide intensive care
that necessitates the quick decision-making
ability, independent working and subdues
sentiments to manage job responsibilities.
Moreover, trivial autonomy and less feedback
may lead to the development of burnout.
Nurses performing duties in risky sectors
including emergency and critical care are most
susceptible to burnout due to patient
requirements and undefined consequences10.
Many researchers have studied burnout in
nurses, and most of these studies concluded
that burnout scores are considerably greater
among hospital nurses11,12. Studies conducted
on burnout in nurses of Pakistan are
insufficient. Recently, a study was carried out
regarding burn out among the pediatric
surgeons of Pakistan13 but there are limited
studies on the factors contributing to burnout
in nurses working in emergency rooms of
public sector hospitals in Pakistan.
METHODOLOGY:
This was an analytical cross- sectional study.
In this study, sample was based on 8 hospitals,
total 150 performas were distributed out of
which the data was collected from nurses
(N=130) working in emergency room through
self-administered questionnaire. A total of 130
responses were approached through purposive
sampling technique with 8% margin of error.
RESULTS:
Table i: Grading Criteria for the Burnout Category &
Results
Burnout Frequencies
No Burnout 04
Mild Burnout 86
Moderate Burnout 40
Severe Burnout
-
Total 130
Note: Here total questions were 19 and each
having 5 marks, then total score rate is 95
1Figure : Comparison of Mean Score among
Burnout Domains
FACTORS CONTRIBUTING TO BURNOUT AMONG NURSES
January-June 2021
14
JFINPH
J Farkhanda Inst Nurs Pub Health
Figure 2: Factors Associated with Nurses Burnout
DISCUSSION:
In this study, burnout was assessed among
nurses working in emergency rooms. Out of
130 respondents, 92% participants were
analyzed as individuals suffering from burnout.
86 participants were categorized as having
mild burnout (68.25%) and 40 (31.74%) were
with moderate burnout. The results were
congruent to the findings which showed that
emergency nurses have higher level of
burnout as compared to nurses working in
medical units14. Another study concluded the
same results that nurses were found
vulnerable to burnout, but emergency room
nurses were more prone to burnout15. Age of
nurses had significant relationship with
personal burnout and work related burnout in
our study. The study results of Kelly et al
agreed to our results that younger age and
working in high complex or critical areas are
predisposing factors for burnout16. Other
studies also revealed similar results that
nurses having age less than 35 experienced
higher levels of burnout17. In this study,
experience has an insignificant relationship
with personal, work-related burnout and the
client related burnout. Another study noted
that years of work and the rank of the nurse in
the organization have positive association with
the level of burnout18. The mean personal and
work related burnout scored were higher in
married as compared to single. Marital status
is correlated with client related burnout.
Another study showed similar results and
concluded that married nurses have higher
levels of burnout compared to single nurses19.
But it is contradicted by another study;
researcher seems that there is no
distinguishable difference in burnout among
married and unmarried nurses19. Whereas
Kelly et al in 2011 proposed that among
nurses being single and childless are
predisposing factors for burnout16. No
relationship of type of residence was found
with personal burnout, work related burnout
and client related burnout in this study.
Whereas, a study finds out that nurses having
difficulty in childcare and in doing house
chores, health problems of the nurse herself or
her children, economic hardships and
difficulties encountered in transportation are
factors that attribute to burnout20. Duty shift
has significant relationship with personal
burnout, work-related burnout and client
related burnout in this study. Other findings
confirmed that nurses working in emergency
have more burnout especially those who
worked in long shifts or night shifts as
compared to those at day shifts20. Another
study on burnout concluded that insufficient
opportunities to rest and regenerate depleted
FACTORS CONTRIBUTING TO BURNOUT AMONG NURSES
January-June 2021
15
JFINPH
J Farkhanda Inst Nurs Pub Health
7. Virgolino A, Coelho A, Ribeiro N. The
impact of perceived organizational
justice, psychological contract, and
the burnout on employee
performance: the moderating role of
organizational support, in the
portuguese context. International
Journal of Academic Research in
Business and Social Sciences.
2017:241-63.
8.
Blew MB.
The association between
burnout and demographic
characteristics of educators living in
boarding schools
(Doctoral
dissertation, University of Pretoria).
9. Selamu M, Thornicroft G, Fekadu A,
Hanlon C. Conceptualisation of job-
related wellbeing, stress and burnout
among healthcare workers in rural
Ethiopia: a qualitative study. BMC
health services research. 2017
Dec;17(1):1-1.
10. Zeng LN, Zhang JW, Zong QQ, Chan
SW, Browne G, Ungvari GS, Chen
LG, Xiang YT. Prevalence of burnout
in mental health nurses in China: A
meta-analysis of observational
studies. Archives of psychiatric
nursing. 2020 Jun 1;34(3):141-8.
11. Molina-Praena J, Ramirez-Baena L,
Gómez-Urquiza JL, Cañadas GR, De
la Fuente EI. Levels of burnout and
risk factors in medical area nurses: A
meta-analytic study. International
journal of environmental research and
public health. 2018 Dec;15(12):2800.
12. Lee HF, Chiang HY, Kuo HT.
Relationship between authentic
leadership and nurses' intent to leave:
The mediating role of work
environment and burnout. Journal of
nursing management. 2019
Jan;27(1):52-65.
13. Khurshied S, Hisam A, Khurshid N,
Khurshid M. Burnout among
surgeons; depression, anxiety and
stress between consultant versus
post-graduate trainee. Pakistan
Journal of Medical Sciences. 2020
Oct 20;36(7).
14. Li H, Cheng B, Zhu XP. Quantification
of burnout in emergency nurses: A
systematic review and meta-analysis.
International emergency nursing.
2018 Jul 1;39:46-54.
energy aggravate the exhausting impact of
demand/resource imbalances21. Therefore,
burnout may be caused by above-mentioned
reasons. It can be alleviated by eliminating
and controlling of these contributing factors of
burnout.
CONCLUSION:
Emergency room nurses have mild to
moderate burnout and work related factors are
significantly related to burnout. There is also
significant relationship of age, experience,
duty shift and marital status with level of
burnout.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES:
1. Wang S, Liu Y, Wang L. Nurse
burnout: personal and environmental
factors as predictors. Int J Nurs Pract.
2015;21(1):78-86.
2. Rushton CH, Batcheller J, Schroeder
K, Donohue P. Burnout and resilience
among nurses practicing in high-
intensity settings. Am J Crit Care.
2015;24(5):412-20.
3. Jennings BM. Work Stress and
Burnout Among Nurses: Role of the
Work Environment and Working
Conditions. In: Hughes RG, editor.
Patient Safety and Quality: An
Evidence-Based Handbook for
Nurses. Rockville (MD): Agency for
Healthcare Research and Quality
(US); 2008.
4. Rice EM, Rady MY, Hamrick A,
Verheijde JL, Pendergast DK.
Determinants of moral distress in
medical and surgical nurses at an
adult acute tertiary care hospital. J
Nurs Manage. 2008;16(3):360-73.
5. Poghosyan L, Clarke SP, Finlayson
M, Aiken LH. Nurse burnout and
quality of care: cross-national
investigation in six countries. Res
Nurs Health. 2010;33(4):288-98.
6. Khalid M, Naeem H. The impact of job
description on burnout with mediating
effect of psychological strain: an
empirical evidence from the cement
industry of Pakistan. Middle East J
-Sci Res. 2013;13(3):288 95.
FACTORS CONTRIBUTING TO BURNOUT AMONG NURSES
January-June 2021
16
JFINPH
J Farkhanda Inst Nurs Pub Health
15. Gómez-Urquiza JL, la Fuente-Solana
D, Emilia I, Albendín-García L,
Vargas-Pecino C, Ortega-Campos
EM. Prevalence of burnout syndrome
in emergency nurses: A meta-
analysis. Critical care nurse. 2017 Oct
1;37(5):e1-9.
16. Kelly LA, McHugh MD, Aiken LH.
Nurse outcomes in magnet® and non-
magnet hospitals. J Nurs Adm.
2011;41(10):428-33.
17. Aiken LH, Sloane DM, Bruyneel L,
Van den HK, Sermeus W. Nurses’
reports of working conditions and
hospital quality of care in 12 countries
in Europe. Int J Nurs Stud.
2013;50(2):143-53.
18. Naz S, Hashmi AM, Asif A. Burnout
and quality of life in nurses of a
tertiary care hospital in Pakistan. J
Pak Med Assoc. 2016;66(5):532-36.
19. Kaplan Serin E, Özdemir A, Işik K.
The effect of nurses' compassion on
burnout: A cross-sectional study.
Perspectives in Psychiatric Care.
2021 Jan;57(1):371-9.
20. Moukarzel A, Michelet P, Durand AC,
Sebbane M, Bourgeois S, Markarian
T, Bompard C, Gentile S. Burnout
syndrome among emergency
department staff: prevalence and
associated factors. BioMed research
international. 2019 Jan 21;2019.
21. Muriithi JW, Kariuki PW. Work-related
determinants of Nurses’ burnout in
Pumwani Maternity Hospital, Nairobi
City County, Kenya. Asian Journal of
Research in Nursing and Health.
2020 Jun 23:36-49.
1. Fouzia Jameel - Concept & Design; Data Acquisition; Data Analysis/Interpretation;
Drafting Manuscript; Critical Revision; Supervision; Final Approval
2. Samina Kousar - Concept & Design; Drafting Manuscript; Critical Revision;
Supervision; Final Approval
3. Nadia Saif - Concept & Design; Data Acquisition; Data Analysis/Interpretation; Drafting
Manuscript; Critical Revision; Supervision; Final Approval
4. Mansoor Ghani - Concept & Design; Data Acquisition; Data Analysis/Interpretation;
Drafting Manuscript; Critical Revision; Supervision; Final Approval
5. Shahjahan - Data Analysis/Interpretation; Drafting Manuscript
6. Waqas Latif - Data Analysis/Interpretation
CONTRIBUTORS
FACTORS CONTRIBUTING TO BURNOUT AMONG NURSES
January-June 2021
17
J Farkhanda Inst Nurs Pub Health
JFINPH
PARENTS’ SATISFACTION WITH NURSING CARE PROVIDED TO THEIR
CHILD IN TERTIARY CARE HOSPITALS, PESHAWAR
Muhammad Anwar1, Shah Hussain2, Shakeel Ahmed3, Abdullah4, Shaida Khan5, Obaid-ul-Haq6,
ABSTRACT:
OBJECTIVES:
To study the satisfaction of parents regarding their child with nursing care in government tertiary care
hospitals in Peshawar, KPK.
METHODOLOGY:
A cross sectional study was done in three tertiary care hospitals in Peshawar District, KPK. Data was
collected from 306 participants as a convenient sample size. Parents of children admitted in three
units consisting of Pediatric Ward, Pediatric Intensive Care Unit (ICU) and Pediatric High Dependency
Unit (HDU) for at least 2 days in these units were included. Whereas, those who have stayed less
than 2 days were excluded. Data was collected from 306 participants through a structured
questionnaire. Informed consent was taken from the participants. The data was recorded and
analyzed on SPSS version 20.0.
RESULTS:
The result of this study shows more satisfaction from parents toward nursing care provided to their
child. But in some areas i.e. providing informational care and following hygienic conditions, the
parents’ satisfaction was not positive.
CONCLUSION:
Parents as well as patient satisfaction are the key factors in relation to nursing care. Our study’s
finding show great satisfaction toward nursing care.
KEYWORDS: Intensive Care Unit (ICU), High Dependency Unit (HDU), Parents’ Satisfaction,
Children, Nursing Care
INTRODUCTION:
Parents’ satisfaction with nursing care
provided to their children is very important.
Nurses and other health professionals should
know the importance of support needed for the
parents and to provide quality care for their
children. Nurses should be aware of how to
bridge the gap and communicate with parents
Correspondence
, Muhammad Anwar Nursing Officer, DHQ Hospital,
Timergara.
-Cell: +92-300 9088935
Email: m.anwar.ma528@gmail.com
, Nursing officer, saidu Group of Teaching Hospital,
Swat.
Nursing Officer, DHQ Hospital Timergara.
Nursing Officer, DHQ Hospital Timergara.
Principal, Advanced Institute of Nursing and Health
Sciences, Karachi.
1
2
3
4
5
6
Principal, Jehlum College of Nursing, Punjab
through their knowledge and skills to support
parental role. Access to information can make
parents feel more comfortable, reduce
How to cite this article:
Anwar M, Hussain S, Ahmed S, Abdullah, Khan S, Obaid-ul-Haq. Parents’ Satisfaction with Nursing Care provided
to Their Child in Tertiary Care Hospitals, Peshawar. J Farkhanda Inst Nurs Pub Health 2021; 1(1): 17-21
January-June 2021
18 J Farkhanda Inst Nurs Pub Health
JFINPH
helplessness, and provide them a sense to
control the situation1. Better nurse/patient
ratio, nurse involvement in decision making,
and positive doctor-nurse relations are also
associated with improved patient outcomes,
including reduction in further complications,
mortality, and better parents’ satisfaction2. The
attitude and approach of the nurses are
important factors, which enable them to treat
children as human being, and not just a case,
with sympathy, respect, and empathy and by
staff who are interested in providing holistic
care3. Parents and nurses are at the forefront
of a hospitalized child’s care and to
understand the views of parents and nurses in
the provision of holistic care to patient.
Parents and children have a unique bond of
relationship, which makes parental
involvement much important to provide the
holistic care to admitted child in pediatrics
unit4. Patient satisfaction levels is a crucial
part to measure the quality of care, especially
for children who has difficulty in speaking, so
parent’s level of satisfaction should be taken
into consideration5. Parents’ satisfaction is
generally accepted as a vital indicator of the
quality and effectiveness of care6. The quality
of care based on nursing care deficiencies
was also explored and indicated that a
significant relationship existed between quality
care and parents of patient safety ratings. The
creation and maintenance of trust is essential
to increase the benefits of the relationship
between nurses and parents of hospitalized
children7. Nurses are the front-line personnel
who care for patients on a daily basis. Nurses
can play an important role in ensuring patient
safety in every unit of hospital3. The results of
a study reported the assessment of parental
satisfaction with nursing care was good.
Enough resources are also one of the factors
to provide better quality care9.
METHODOLOGY:
A cross sectional quantitative study design
was used to find out the satisfaction level of
parents in three government tertiary care
hospitals in Peshawar district, Khyber
Pakhtunkhwa from February to April 2020.
The convenience sampling method was used
and total 306 participants were recruited.
Parents of children admitted in three units
consisting of Pediatric Ward, Pediatric ICU
and Pediatric HDU for at least 2 days in these
units were included. Whereas, those who have
stayed less than 02 days were excluded. Data
was collected from 306 participants through a
structured questionnaire. The questionnaire
consisted of 20 questions based on various
aspects of nursing care. The satisfaction level
was graded to follow the Likert scale as;
Never-1, Sometimes-2, Usually-3, and
Always-4. Approval to carried out the study
was taken from the hospital director. Informed
consent was obtained from all participants.
Data was processed and analyzed using the
SPSS version 20.
RESULTS:
Table i: Demographic Data (in Percentage)
Gender
Male
61
19.9%
Female
245
80.1%
Age
25 to 30 years
143
46.7%
31 to 35 years
133
43.5%
36 to 40 years
29
09.5%
41 and above
01
0.3%
Ward
Pediatric General ward
265
86.6%
ICU
08
02.6%
HDU
33
10.8%
Parents
Father
61
19.9%
Mother
245
80.1%
Residence
Urban
121
39.5%
Rural
185
60.5%
PARENT’S SATISFACTION WITH NURSING CARE
January-June 2021
19
JFINPH
J Farkhanda Inst Nurs Pub Health
Table ii: Overall Results (Variables 1 to 20)
Questions
Serial No.
Participants Responses
Never
N (%)
Sometimes
N (%)
Usually
N (%)
Always
N (%)
Nurses listen carefully
to your concerns
05 (1.6)
28 (9.2)
63 (20.6)
210 (68.6)
They provide effective
nursing care during
every procedure to
your child
06 (2.0)
16 (5.2)
70 (22.9)
214 (69.9)
Nurses provides
informational care to
you
37 (12.1)
71
(23.2)
70 (22.9)
128 (41.8)
1
2
3
4
Behavior of nursing
staff
13 (4.2)
15 (4.9)
67 (21.9)
211 (69)
Overall quality of care
of the nursing staff
15 (4.9)
18 (5.9)
73 (23.9)
200 (65.4)
The nurses follow the
hygienic conditions
93 (30.4)
108
(35.3)
31 (10.1)
74 (24.2)
Give medications on
time
12 (3.9)
26 (8.5)
107 (35.0)
161 (52.6)
Nurse communicate
doctor’s messages
with you regarding
your child health
status
06 (2.0)
40
(13.1)
74 (24.2)
186 (60.8)
I am satisfied from
overall hospital care
05 (1.6)
15 (4.9)
61 (19.9)
225 (73.5)
Your child receives
satisfactory treatment
03 (1.0)
15 (4.9)
56 (18.3)
232 (75.8)
5
6
7
8
9
10
11
Positive work climate
and cooperation
among staff members
02 (0.7)
10 (3.3)
38 (12.4)
256 (83.7)
DISCUSSION:
The satisfaction of the parents of those
children admitted in pediatric wards in three
teaching hospitals of Peshawar was studied.
Charge nurse is the principal healthcare
provider for the neonatal patients admitted in
the ICU and HDU. They have greater
responsibilities for giving the effective care
to infants, listening to their parents concerns
and providing information care to them along
with health status of their children. These
factors contribute in the parent’s satisfaction
regarding the services and nursing
staff10,11,12. Similarly, in our study, parents
scores were high on the questions such as
active listening of the nurses, effective care,
behavior, and overall quality of nursing care
but they reported that 35.5% of the nursing
staff doesn’t follow the hygienic conditions.
To minimize chances of infection, following
hygienic conditions is very important before
and after performing procedure. Due to work
burden, shortage of staff, and lack of
facilities, proper hygienic conditions are not
practiced in hospitals. A study conducted in
Jordan13, reported that ninety per cent of the
parents perceived that nursing staff show
negligence in the care of their children and
didn’t listen to parents’ concerns. Similarly,
another study result showed that the parents
were less satisfied from the nursing care
provided to their six-year-old children
Figure 1 : showing satisfaction of the parents
with nursing care
PARENT’S SATISFACTION WITH NURSING CARE
January-June 2021
20 J Farkhanda Inst Nurs Pub Health
admitted in emergency units14,15. This study
also reported that duration of hospitalization,
gender and age were not associated with
the satisfaction of the parents. In our study,
the results showed that most of the
participants were satisfied with nursing care
provided to their child. Patient satisfaction
with nursing care is a definitive determinant
of quality of healthcare in the hospital16. An
integrative review was conducted and
reported that several countries (United
Kingdom, United States of America,
Australia, Canada, Israel, Netherland, and
South Africa) showed parents satisfaction
with nursing care provided to their infants17.
In USA18, parents were highly satisfied from
the nurses performing duties in the
emergency care units of neonatal.
CONCLUSION:
This study concluded that the majority of the
parents were satisfied with the overall care
provided by nurses except hand washing and
the provision of information for which
responses were not satisfactory. The
remaining variable got more than 50%
(positive) score.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES:
1. Murata A. Doctor, Nurse, Patient
Relationships: Negotiating Roles and
Power A Case Study of Decision-
Making for C-sections (Doctoral
dissertation).
2. Kang XL. Association of nurse-
physician teamwork and hospital
surgical patient mortality.
3. Navin MC, Wasserman JA. Reasons
to amplify the role of parental
permission in pediatric treatment. The
American Journal of Bioethics. 2017
Nov 2;17(11):6-14.
4. Fisher D, Khashu M, Adama EA,
Feeley N, Garfield CF, Ireland J,
Koliouli F, Lindberg B, Nørgaard B,
Provenzi L, Thomson-Salo F. Fathers
in neonatal units: Improving infant
health by supporting the baby-father
bond and mother-father coparenting.
Journal of Neonatal Nursing. 2018
Dec 1;24(6):306-12.
5. Hockenberry MJ, Wilson D. Wong's
nursing care of infants and children-E-
book. Elsevier Health Sciences; 2018
Oct 1.
6. Latour JM, Hazelzet JA, van der
Heijden AJ. Parent satisfaction in
pediatric intensive care: a critical
appraisal of the literature. Pediatric
critical care medicine. 2005 Sep
1;6(5):578-84.
7. Trajkovski S, Schmied V, Vickers MH,
Jackson D. Experiences of neonatal
nurses and parents working
collaboratively to enhance family
centred care: The destiny phase of an
appreciative inquiry project. Collegian.
2016 Sep 1;23(3):265-73.
8. Salmani N, Abbaszadeh A, Rasouli
M, Hasanvand S. The process of
satisfaction with nursing care in
parents of hospitalized children: a
grounded theory study. International
Journal of Pediatrics. 2015 Nov
1;3(6.1):1021-32..
9. Aiken LH, Sloane DM, Bruyneel L,
Van den Heede K, Sermeus W,
Rn4cast Consortium. Nurses’ reports
of working conditions and hospital
quality of care in 12 countries in
Europe. International journal of
nursing studies. 2013 Feb
1;50(2):143-53.
10. Ding X, Zhu L, Zhang R, Wang L,
Wang TT, Latour JM. Effects of
family-centred care interventions on
preterm infants and parents in
neonatal intensive care units: a
systematic review and meta-analysis
of randomised controlled trials.
Australian Critical Care. 2019 Jan
1;32(1):63-75.
11. Aslanabadi S, Shahbazi SH. Mothers’
satisfaction with nursing care in a
Children’s Hospital. Iran Journal of
Nursing. 2014 Feb;26(86):61-70.
12. Matziou V, Boutopoulou B,
Chrysostomou A, Vlachioti E,
Mantziou T, Petsios K. Parents'
satisfaction concerning their child's
hospital care. Japan Journal of
Nursing Science. 2011 Dec;8(2):163-
73.
13. Abuqamar M, Arabiat DH, Holmes S.
Parents' perceived satisfaction of
JFINPH
PARENT’S SATISFACTION WITH NURSING CARE
January-June 2021
21
J Farkhanda Inst Nurs Pub Health
care, communication, and
environment of the pediatric intensive
care units at a tertiary children's
hospital. Journal of pediatric nursing.
2016 May 1;31(3):e177-84.
14. Kruszecka-Krówka A, Smoleń E,
Cepuch G, Piskorz-Ogórek K, Perek
M, Gniadek A. Determinants of
Parental Satisfaction with Nursing
Care in Paediatric Wards—A
Preliminary Report. International
journal of environmental research and
public health. 2019 Jan;16(10):1774.
15. Teksoz E, Bilgin I, Madzwamuse SE,
Oscakci AF. The impact of a creative
play intervention on satisfaction with
nursing care: A mixed-methods study.
Journal for Specialists in Pediatric
Nursing. 2017 Jan;22(1):e12169.
16. Hagen IH, Iversen VC, Nesset E,
Orner R, Svindseth MF. Parental
satisfaction with neonatal intensive
care units: a quantitative cross-
sectional study. BMC health services
research. 2019 Dec;19(1):1-2.
17. Butt ML, McGrath JM, Samra HA,
Gupta R. An integrative review of
parent satisfaction with care provided
in the neonatal intensive care unit.
Journal of Obstetric, Gynecologic &
Neonatal Nursing. 2013 Jan
1;42(1):105-20.
18. Lake ET, Smith JG, Staiger DO,
Hatfield LA, Cramer E, Kalisch BJ,
Rogowski JA. Parent satisfaction with
care and treatment relates to missed
nursing care in neonatal intensive
care units. Frontiers in pediatrics.
2020;8.
CONTRIBUTORS
1. Muhammad Anwar - Concept & Design; Data Acquisition; Data
Analysis/Interpretation; Drafting Manuscript; Critical Revision; Final Approval
2. Shah Hussain - Data Acquisition; Drafting Manuscript; Critical Revision
3. Shakeel Ahmed - Data Analysis/Interpretation
4. Abdullah - Data Analysis/Interpretation; Drafting Manuscript
5. Shaida Khan - Critical Revision; Supervision
6. Obaid-ul-Haq – Supervision; Final Approval
JFINPH
PARENT’S SATISFACTION WITH NURSING CARE
January-June 2021
22
JFINPH
J Farkhanda Inst Nurs Pub Health
PERCEPTION OF STUDENT NURSES REGARDING CHARACTERISTICS OF
AN EFFECTIVE CLINICAL INSTRUCTOR: A CROSS-SECTIONAL STUDY
Amanullah Khan1, Sehrish Naz2, Nishat Begum3
ABSTRACT:
OBJECTIVES:
This study was conducted to explore the perception of student nurses regarding characteristics of
effective clinical instructor that can boost student’s learning.
METHODOLOGY:
A descriptive cross-sectional study design was used to carry out to find out the student’s perception
regarding characteristics of effective clinical instructor. For this purpose, a structured questionnaire was
used for data collection. Participants of the study were undergraduate student nurses enrolled in BSc.N
Post R.N, BSc.N Generic and Diploma nursing educational programs. Total 250 students’ responses
were recorded from different institutes of nursing, Peshawar. Ethical approval was taken from Khyber
Medical University, Peshawar. SPSS version 22.0 was used for data analysis.
RESULTS:
The results showed that all the characteristics of professional competency was important for the
instructors. Perceived good communication skills was marked high in personal characteristic of the
instructors (52%). The instructors should evaluate the students objectively (72%) had increased
responses under the category of relationship with students.
CONCLUSION:
For a good instructor, professional competency, personal characteristics, and relationship with students
should be effective. The instructors should have to polish their skills.
KEYWORDS: Clinical Instructor, Clinical Teaching, Perception, Student Nurses, Characteristics,
Effective Clinical Instructor
How to cite this article:
Khan A, Naz S, Begum N. Perception Of Student Nurses Regarding Characteristics Of An Effective Clinical Instructor: A
Cross-Sectional Study. . 2021; 1(1): 22-26 J Farkhanda Inst Nurs Pub Health
Correspondence
1Amanullah Khan, Nursing Officer (Regst)
Hayatabad Medical Complex, Peshawar
cell: +92 -315-6868926
Email: khanamanuol@gmail.com
2
3Lecturer, institute of Nursing, KMU Peshawar
Nursing Officer, DHQ Timergara
INTRODUCTION:
In almost all countries of the world, nurses
constitute the biggest part of the health care
January-June 2021
services1. According to the World Health
Organization, there are 19.3 million nurses
and midwives working globally2. Clinical
teaching is a process in which planned
activities are performed in a working area in
order to boost the factual learning and
attitudes of the learners and make them able
to easily perform technical work related to
their profession3. According to Niederriter,
Eyth and Thoman, clinical teaching is a mean
to translate theory into practice and due
attention is paid toward polishing technical
skills and affective capabilities of the learners
23
JFINPH
J Farkhanda Inst Nurs Pub Health
instead of merely increasing factual
information4. The job of the clinical teacher is
to enable learners to shoulder the
responsibilities of a professional nurse in a
prescribed span of time4. Nurses wanting in
basic required skills are likely to jeopardize
effectiveness of a health care providing team
and may simultaneously reduce effectiveness
of nursing interventions. There are many
studies that are suggestive of the fact that
effective behaviors of a clinical instructor are
closely related to effective clinical teaching
that leads to enhanced learning capacity of
the learners at bed side5.Several studies are
of the opinion that clinical teaching is a
valuable tool used to bridge the theoretical
knowledge and clinical skills in a practical
profession like nursing. Effective clinical
teaching is directly related to the quality of
professional skills that the student nurses
receive during their training period. If the
clinical teaching is effective, in turn, it will
ingrain good quality of knowledge, skills, and
attitudes in the student nurses who will
provide safe and effective nursing services to
their clients, families and communities. It will
also increase their interpersonal
communication and relationship abilities with
others6,7. Girija et al, pointed out three main
functions of a clinical teacher that are
important for making the clinical learning of
the student nurses easier8. These functions
include role modeling, clinical supervision,
and instructional leadership. In addition, they
also explain the most important attributes of
clinical teacher as professional competencies,
interactions with students and personal
qualities8. Lundberg KM elucidated that
clinical teaching is a way to translate
theoretical knowledge into practical
performance9. Paying due attention to the
importance of effective clinical teaching, many
research studies have been done so far, to
find out how the clinical teaching can be
improved by knowing about perception of
student nurses regarding characteristics of
effective clinical teacher9. Effective clinical
teaching is a mean to produce professional
nurses who would possess optimum level of
theoretical knowledge and practical skills. It is
of utmost importance for hiring and
development of the clinical instructors to have
valid knowledge about the behaviors and
characteristics of an effective clinical teacher
that increase or decrease the learning abilities
of the student nurses.
METHODOLOGY:
A cross sectional descriptive study design
was employed. The sample of this study was
selected through convenient sampling
technique, consisting of two hundred and fifty
participants (n=250), recruited from various
nursing educational programs from different
nursing colleges of the Peshawar. Duration of
the study was four months from February to
June 2020. Students of seventh and eight
semester of the generic BSN and third and
fourth year of diploma program were included
in this study. Exclusion criterion was students
who attended less than three clinical
sessions during their study tenure. A self-
administered instrument adopted and
modified from Effective Clinical Instructor
Characteristics Inventory (ECICI) developed
by Girija et al, was used for data collection8.
The Cronbach’s Alpha coefficient
demonstrating the reliability of the instrument
was 0.87. The questionnaire items were
related to the professional competence,
relationship with students and personal
characteristics of the clinical instructor,
respectively. A five-point Likert scale was
used. Ethical approval was taken from
Institutional Review Board of Khyber Medical
University Peshawar. informed consent was
obtained from all the participants.
Confidentiality and anonymity of participants
were maintained. The data were analyzed
using the Statistical Package for the Social
Sciences (SPSS) version 22. Descriptive
statistics including were used to identify
student’s perception regarding characteristics
of effective clinical instructor.
PERCEPTION OF STUDENT NURSES
January-June 2021
24
JFINPH
J Farkhanda Inst Nurs Pub Health
RESULTS:
Table i: Demographic Information
Yes No
Male Female
52
-
Age
20 25
years
-26 30
years
250
-31 35
years years
>36 Total
131
(52.4%)
95
(38%)
18
(7.2%)
08
(2.4%) 250
Gender
(20.8%)
198
(79.2%)
Educational
Program
Post
RN
BSc.N
Generic
BSc.N
Diploma in
Nursing
250
146
(58.4%)
56
(22.4%) 48 (19.2%)
Previous
Clinical
Experience
250
139
(39.6%)
111
(44.4%)
Figure 1. Characteristics Related to the
Category of Professional Competence
2Figure : Characteristics Related to the Category of
Personal Attributes
Figure 3: Characteristics Related to the
Category of Relationship with Students
DISCUSSION:
The findings of this study clearly show that
most of the characteristics reported by
student nurses belong to category of
professional competence. These findings are
supporting the work of INGRAssIA10 and
Kotzabassaki et al11, in which the category of
professional competence had received
highest rating from the participating students.
The findings of this study are also partly in
line with the study conducted by Girija et al8,
in Oman, in which they found that the
professional competence was the highest
rated theme of most important characteristics
as perceived by the students, followed by the
theme of relationship with students, whereas
the findings of this study show that the
second highly rated category is Personal
Attributes. Studies done in the field of
radiography also revealed that the students
gave over all highest scores to the
professional competence, followed by
category of interpersonal relationships12.
Similarly, the findings of two studies
conducted by Emery13 and Jarski, Kulig, and
Olson14 in the field of physical therapy, are in
support of the findings of the current study.
The results of other studies carried out in
athletic training programs, revealed that
relationship with students was rated as the
most important characteristic, by the
participants of these studies15. Other most
rated attributes of effective clinical instructor
include, being able to communicate
knowledge and skills to students for safe
practices, demonstrates good communication
skills and being honest and direct with
students. These findings of current study are
in line with the study of Talwar and Weilin16,
in which the researchers found that
PERCEPTION OF STUDENT NURSES
January-June 2021
25
JFINPH
J Farkhanda Inst Nurs Pub Health
participants gave more importance to
characteristics of being honest with students,
having good communication skills and ability
to give constructive feedback. However,
these findings don’t agree with the results of
study where rapport was given the highest
score by the participants17. Other highly rated
characteristic in this study are that clinical
instructor is organized, well prepared and
demonstrates enthusiasm for teaching.
These findings are also supported by work of
other researchers, who agree that these
qualities are fundamental for effectiveness of
a clinical instructor18.
CONCLUSION:
Parents as well as patient satisfaction are
the key factors in relation to nursing care.
Our study’s finding show great satisfaction
toward nursing care.
CONFLICT OF INTEREST: None
FUNDING SOURCES: None
REFERENCES:
1. Schönwetter DJ, Lavigne S, Mazurat
R, Nazarko O. Students’ perceptions
of effective classroom and clinical
teaching in dental and dental hygiene
education. J Dent Educ.
2006;70(6):624-35.
2. WHO. World Health Statistics Report
[Internet]. 2016. Available from:
http://www.who.int/gho/publications/w
orld_health_statistics/EN_WHS2011_
Full.pdf
3. Gower S, Duggan R, Dantas JA,
Boldy D. Something has shifted:
Nursing students’ global perspective
following international clinical
placements. Journal of advanced
nursing. 2017 Oct;73(10):2395-406.
Niederriter JE, Eyth D, Thoman J.
Nursing students’ perceptions on
characteristics of an effective clinical
instructor. SAGE Open Nurs.
2017;3:2377960816685571.
4. Kaphagawani NC, Useh U. Analysis
of nursing students learning
experiences in clinical practice:
literature review. Stud Ethno-Med.
2013;7(3):181-5.
5. Smedley AM. Becoming and being a
preceptor: a phenomenological study.
J Contin Educ Nurs. 2008;39(4):185-
91.
6. Ousey K. Bridging the theory–practice
gap? the role of the
lecturer/practitioner in supporting pre-
registration students gaining clinical
experience in an orthopaedic unit. J
Orthop Nurs. 2016;4(3):115-20.
7. Madhavanprabhakaran GK, Shukri
RK, Hayudini J, Narayanan SK.
Undergraduate nursing students’
perception of effective clinical
instructor: Oman. Int J Nurs Sci.
2013;3(2):38-44.
8. Park S. Effects of an intensive clinical
skills course on senior nursing
students' self-confidence and clinical
competence: A quasi-experimental
post-test study. Nurse education
today. 2018 Feb 1;61:182-6.
9. INGRAssIA JM. Effective radiography
clinical instructor characteristics. Am
Soc Radiol Tech. 2011;82(5):409-20.
10. Peranginangin M. Nursing Students
Perceptions of Effective Clinical
Instructors Characteristics. InAbstract
Proceedings International Scholars
Conference 2019 Dec 18 (Vol. 7, No.
1, pp. 652-659).
11. Parvan K, Hosseini FA, Bagherian S.
The relationship between nursing
instructors' clinical teaching behaviors
and nursing students' learning in
Tabriz University of Medical Sciences
in 2016. Education for Health. 2018
Jan 1;31(1):32.
12. Mosca CK. The relationship between
emotional intelligence and clinical
teaching effectiveness. Teaching and
Learning in Nursing. 2019 Apr
1;14(2):97-102.
13. Reising DL, James B, Morse B.
Student perceptions of clinical
instructor characteristics affecting
clinical experiences. Nursing
education perspectives. 2018 Jan
1;39(1):4-9.
14. Eldred CM, Neil ER, Dougal ZJ,
Walker SE, Grimes AM, Eberman LE.
Preceptor Perceptions of the
Immersive Clinical Experience in
Athletic Training Education. Athletic
Training Education Journal. 2021
Jan;16(1):42-52.
PERCEPTION OF STUDENT NURSES
January-June 2021
26
JFINPH
J Farkhanda Inst Nurs Pub Health
15. Talwar DS, Weilin S. Qualities of an
effective teacher: the dental faculty
perspective. J Dent Educ.
2005;69(2):116.
16. Aldhahir AM, Naser AY, Gardenhire
DS. Respiratory Therapy
Administrators' Perceptions of
Effective Teaching Characteristics of
Clinical Preceptors. Respiratory care.
2020 Feb 1;65(2):191-7.
17. Soriano, G., & Aquino, M. G. (2017).
Characteristics of a good clinical
teacher as perceived by nursing
students and faculty members in a
Philippine University College of
Nursing. Int. J. Nurs. Sci, 7, 96-101.
18. Mikkonen K, Ojala T, Sjögren T,
Piirainen A, Koskinen C, Koskinen M,
Koivula M, Sormunen M, Saaranen T,
Salminen L, Koskimäki M.
Competence areas of health science
teachers–a systematic review of
quantitative studies. Nurse education
today. 2018 Nov 1;70:77-86.
CONTRIBUTORS
1. Amanullah Khan - Concept & Design; Data Acquisition; Data Analysis/Interpretation;
Drafting Manuscript; Critical Revision; Supervision; Final Approval
2. Sehrish Naz - Concept & Design; Data Analysis/Interpretation; Drafting Manuscript;
Critical Revision; Final Approval
3. Nishat Begum - Concept & Design; Data Acquisition; Data Analysis/Interpretation
PERCEPTION OF STUDENT NURSES
January-June 2021
27
JFINPH
J Farkhanda Inst Nurs Pub Health
January-June 2021
To conduct research to a lower standard may constitute misconduct. Publishers and editors shall take reasonable
steps to identify and prevent the publication of papers where research misconduct has occurred, including
plagiarism, citation manipulation, and data falsification/fabrication, among others. If tables, illustrations or
photographs, which have already been published, are included, a letter of permission for re-publication should be
obtained from author(s) as well as the editor of the journal where it was previously published. Written permission to
reproduce photographs of patients, whose identity is not disguised, should be sent with the manuscript.
According to principles of transparency and best practice in scholarly publishing a good research should be justified,
well planned, appropriately designed, and ethically approved in accordance to Committee On Publication Ethics
(COPE), Open Access Scholarly Publishers Association (OASPA), Directory of Open Access Journals (DOAJ) and
World Association of Medical Editors (WAME).
PUBLICATION ETHICS POLICIES
If a medicine is used, generic name should be indicated. The commercial name may, however, be mentioned only
within brackets, if necessary. In case of medicine or device or any material indicated in text, a declaration by author(s)
should be submitted that no monetary benefit has been taken from manufacturer/importer of that product by any
author. In case of experimental interventions, permission from ethical committee of the hospital should be taken
beforehand. Any other conflict of interest must be disclosed. Fully informed consent should always be sought. It may
not always be possible, however, and in such circumstances, an appropriately constituted research ethics
committee should decide if this is ethically acceptable.
International Committee of Medical Journal Editors (ICMJE) recommendations are followed to review best practice
and ethical standards in the conduct and reporting of the manuscript and other material published in the journal, and
to help authors, editors and other involved in peer review and biomedical publishing create and distribute accurate,
clear, reproducible, unbiased research articles. The role of authors and contributors are also according to ICMJE
recommendations which are based on four criteria; available on The “Authorship Contribution Form” www.icmje.org
is available on our official website www.jgmds.org.pk
Two hard copies and a soft copy (MS Word format) of the manuscript should be submitted by post. In addition,
articles can be submitted online via email ( ). A duly filled-in “Author Agreement Form” editor.jfinph@gandhara.edu.pk
is mandatory for publication with a covering letter containing the undertaking, certifying the originality of the work.
INSTRUCTIONS TO AUTHORS
Journal of Farkhanda Institute of Nursing and Public Health(JFINPH) aims to be the leading publication in its field and
provides a platform for the exchange of information about new and significant research as well as to motivate the
conduct and publication of original research in medical and dental sciences in Pakistan and throughout the world.
The journal will publish peer-reviewed research articles, meta-analysis, systematic reviews, clinical developments,
clinical opinions and treatments as well as other key issues of relevance to medicine and dentistry. It would provide
clinicians, scientist and students of medical and dental sciences with a comprehensive periodical published twice a
year.
All material submitted for publication should be sent exclusively to the JFINPH. Work that has already been reported
in a published paper or is described in a paper sent or accepted elsewhere for publication should not be submitted.
Multiple or duplicate submission of the same work to other journal should be avoided as this fall into the category of
publication fraud.
28
JFINPH
J Farkhanda Inst Nurs Pub Health
i. Objective
iii. Results
Study design and sampling methods should be mentioned. Obsolete terms such as retrospective studies should not
be used. The selection of the observational or experimental subjects (patients or experimental animals, including
controls) should be described clearly. The methods and the apparatus used should be identified (with the
manufacturer's name and address in parentheses), and procedures be described in sufficient detail to allow other
workers to reproduce the results. References to established methods should be given, including statistical methods.
References and brief descriptions for methods that have been published but are not well-known should be provided;
only new or substantially modified methods should be described in detail, giving reasons for using them, and
evaluating their limitations. All drugs and chemicals used should be identified precisely, including generic name(s),
dose(s), and route(s) of administration. The approval of human or animal research by an Ethical committee is an
essential requirement. For statistical analysis, the specific test used should be named, preferably with reference for
an uncommon test.
RESULTS
Legends to illustrations should be typed on the same sheet. Tables should be simple, and should supplement rather
than duplicate information in the text; tables repeating information will be omitted. Each table should have a title and
be typed in double space without horizontal and vertical lines on an 8-1/2”x11” (21.5x28.0 centimeters) paper. Tables
should be numbered consecutively with Roman numerals. If abbreviations are used, they should be explained in
footnotes. When graphs, scatter grams, or histograms are submitted, the numerical data on which they are based
The main components of any original article are Abstract, Introduction, Methodology, Results and Discussion
(IMRAD: I- Introduction, M- Methodology, R- Results and D- Discussion) and Conclusion.
ABSTRACT
Abstract of an original article should be in structured format with the following subheadings:
ii. Methodology
iv. Conclusion
v. Keywords
Label each section clearly with the appropriate subheadings. Background is not needed in an abstract. The total
word count of abstract should be 250 words. A minimum of three to ten keywords as per MeSH (Medical Subject
Headings) should be written at the end of abstract.
INTRODUCTION
The introduction of the article is funnel shaped, moving from the general information followed by specific information
related to the research. It should include the purpose of the article after giving brief literature review strictly related to
objective of the study. The rationale for the study or observation should be summarized. Only strictly pertinent
references should be cited and the subject should not be extensively reviewed. Data, methodology or conclusion
from the work being reported should not be presented in this section. It should end with a statement of the study
objective.
METHODOLOGY
Results should be presented in a logical sequence in the text, tables, and illustrations. It should be written in past
tense. All the data in the tables or illustrations should not be repeated in the text; only important observations should
be emphasized or summarized with due statement of demographic details. No opinion should be given in this part of
the text. The maximum number of tables/graphs should not exceed five.
TABLES AND ILLUSTRATIONS
January-June 2021
29
JFINPH
J Farkhanda Inst Nurs Pub Health
should be supplied. All graphs should be made with MS Excel and SPSS software and be sent as a separate Excel
file, even if merged in the manuscript.
System international (S.I) unit measurement should be used. Imperial measurement units like inches, feet etc. are
not acceptable.
Conclusion should be provided under separate heading and highlight new aspects arising from the study. It should
be in accordance with the objectives. This section is brief, not more than a few pertinent lines.
Photographs, X-rays, CT scans, MRI and photo micro-graphs should be sent in digital format with minimum
resolution of 3.2 mega pixels in JPEG compression. Photographs must be sharply focused. The background of
photographs must be neutral and preferably white. The photographs submitted must be those originally taken as
such by a camera without manipulating them digitally. The hard copy of the photographs if sent, must be uncounted,
glossy prints 5”x7” (12.6x17.3 centimeters) in size. They may be in black and white or in color. Negatives,
transparencies, and x-ray films should not be submitted. Numerical number in the figure and the name of the article
should be written on the back of each figure/photograph. Scanned photographs must have 300 or more dpi
resolution. The author must identify the top of the figure. These figures and photographs must be cited in the text in
consecutive order. Legends for photomicrographs should indicate the magnification, internal scale and the method
of staining. Photographs of published articles will not be returned. If photographs of patients are used either they
should not be identifiable or the photographs should be accompanied by written permission to use them.
LIMITATIONS
S.I UNITS
FIGURES AND PHOTOGRAPHS
The discussion should begin with a brief summary of the main findings and should answer the question(s) stated in
the introduction or address the hypothesis. The findings should be in context of the strengths of the study. This
section should include author's comment on the results, supported with contemporary references, including
arguments and analysis of identical work done by other workers. The differences from previous findings need to be
documented, reason for similarities and differences with applications, implications or both. Typically, the authors
should move from specific to general (opposite of introduction and hence inverted funnel shaped). Any conflict of
interest, however, must be mentioned at the end of discussion in a separate heading.
The limitations of the study should be mentioned at the end. Limitations must be mentioned by the authors, rather
than by the peer reviewers and readers.
The references must be written in Vancouver style, double-spaced and numbered as they appear in the text. The
minimum number of references should be 18; and the total number must not exceed 40 for original article and 100 for
review article. Provide complete information for each reference, including names and initials of all authors when they
are six or less. If there are more than six authors, list the first six followed by “et.al”. The author name(s) and initials are
followed by the title of the article, the name of the journal abbreviated according to the style followed in Index
Medicus, year of publication, journal volume, journal issue and number of the first and last pages. EndNote can be
used for citation in the text and reference list. For credit to individuals involved in the work and conflict of interest, it is
important to have authenticity, accuracy and originality for the publication; following the guidelines of Committee on
Publication Ethics (COPE).
CONCLUSION
DISCUSSION
REFERENCES
January-June 2021
30
JFINPH
J Farkhanda Inst Nurs Pub Health
The author is responsible to ensure that the work submitted is original literary work, given due credit by providing
appropriate citations to the words and work of others. Plagiarism is deemed unethical publishing conduct and
unacceptable. According to HEC policy, the similarity index of more than 19% will be rejected.
PEER REVIEW
PLAGIARISM
JFINPH is a peer reviewed journal. Submitted manuscripts are reviewed for originality, relevance, statistical
methods, significance, adequacy of documentation, reader interest and composition. Every paper will be read by at
least two staff editors of the Editorial Board. The papers selected will then be sent to two external reviewers. If
statistical analysis is included, further examination by a staff statistician will be carried out. The ultimate authority to
accept or reject the manuscript rests with the Editor. We use Open and Blind Review Policy.
All rights of JFINPH are reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, electronic, mechanical, photocopying (except for internal or personal use)
without the prior permission of the publisher.
PUBLICATION AND DISTRIBUTION
Dr. Sofia Shehzad
The publication and the members of the editorial board cannot be held responsible for errors or for any
consequences arising from the use of the information contained in this journal.
Address for Correspondence
Gandhara University, Canal Road, University Town, Peshawar, Pakistan
Tel: +92 (0)91 5619671-6
+92 (0)91 5711151-3
Fax: +92 (0)91 5844428
Managing Editor, Journal of Gandhara Medical and Dental Sciences
JFINPH publication is biannual, and for every published work, copies of the journal will be supplied free of cost to the
principal author and co-author(s). Additional copies of the journal can be obtained from publication office JFINPH.
There are no submission/processing/subscription charges till date.
The journal will be published and circulated to libraries, institutes and clinics throughout Pakistan and abroad.
Website: www.jgmds.org.pk
Email: sofia.kabir@gandhara.edu.pk
editor: jfinph@gandhara.edu.pk
January-June 2021
31
JFINPH
J Farkhanda Inst Nurs Pub Health
January-June 2021
* All author(s) should re
submitted along with the article *
Title of the Article:
The undersigned (after reviewing criteria for authorship as defined by International Committee of Medic
found at `http: //www/icmje.org/` and have participated reasonably in the intellectual content, analysis of data and writing
article), jointly and severally, hereby transfer and assign all rights, title, and interest there
forms and media now or hereafter known to the Journal of Farkhanda Institute of Nursing and Public Health
I/We certify that;
1)
2)
3)
4)
5)
6)
7)
Name of author(s) in order.
Author(s) Name:
1)..............................................................................
2)..............................................................................
3)..............................................................................
4)................
5).......................................................................
6)..............................................................................
AUTHOR’S CHECKLIST
AUTHOR AGREEMENT
ad the following carefully. A completed copy of this form must be signed by each author and
al Journal Editors [ICJME]
of the
in, including any and all copyrights in all
(
JFINPH) The author(s)
retain exclusive right to use part or all of the article in future work of their own, pthe non- rovided proper credit is given to the
case, the submitted article is not published, the Editorial Board agrees to release its rights therein.
JFINPH. In
None of the material in the manuscript has been published previously/currently under
consideration for publication elsewhere.
The article has not been accepted for publication elsewhere.
I/We have not signed any right or interest in the article to any third party.
I/We are willing to produce the data on which this article is based, should
the Editorial Board of JFINPH
request such data.
Animal Care Committee/Institutional Review Board approval was granted for this study. I/We (including spouse and children),
disclose financial interest at the level:
a)
Nothing to disclose b) Financial interest to the amount of: ________________________.
I/We confirm to comply fully with the suggestions/critical views of the reviewer(s)/editor(s), failing which my/our article may be
rejected at the sole discretion of the editor(s). I/We further confirm that if
my/our article is rejected; which is the sole discretion
of the editor(s), I/We will have no right to complain against the journal/editor(s)/representative(s) of the journal/printer in any
forum including the court of law.
I/We suggest the following to overseas reviewer(s) to review my/our article.
Phone/Email:
Signature:
...................................................................................... ...........................
...................................................................................... ...........................
...................................................................................... ...........................
..............................................................
...................................................................................... ...........................
.......
...................................................................................... ...........................
...................................................................................... ...........................
i)
Eliminate non-standard abbreviation in the titles.
ii)
Supply full name of author(s) including
institutions.
iii)
Abstract: (maximum) 250 words. Keyword:
(minimum) 5 keywords. Article: (maximum)
2000-3000 words (excluding references,
tables/illustrations).
iv)
The number of tables/illustrations should not
exceed 5. References: (minimum) 18, recent
last five years citation.
v)
Supply references in Vancouver style,
accurately cited
in the text in numerical order.
vi)
Send 02 hard copies in a protective envelope
and do not use clips.
vii)
Submit the paper via emails given below;
sofia.kabir@gandhara.edu.pk
and
editor.jfinph@gandhara.edu.pk
viii)
Cite tables/figures in the text in numerical
order.
ix)
All authors must sign Authorship Contribution
Form, confirming he or she has made the
contributions listed in the form.
x)
Author agreement is signed by all the authors
(principal author and co-authors).
Approval certificate from research ethical committee
ISSN:
2788-5704
Month: _______________
Vol. _____ No. _____
J Farkhanda Inst Nurs Pub Health
www.jgmds.org.pk
