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International Journal of
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Jul–Dec 2016
eISSN: 2455-6351
IJNSPR
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International Journal of Nursing
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International Journal of Nursing
Science Practice and Research
International Journal of Nursing Science Practice and Research is a peer reviewed journal and provides a
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Focus and Scope oftheJournal
 Nursing administration and management
 Nursing theory and practice
 Nurse education
 Emergency nursing
 Geriatric nursing
 Palliative nursing
 Assessment and diagnosis
 Community health nursing
 Home health nursing
 Forensic nursing
 Nursing informatics
 Telenursing
 Preoperative nursing
 Intellectual disability nursing
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Rekha Rani
Commissioning Editors
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Manisha Dhoble

EDITORIAL BOARD MEMBERS
Dr. Christos F. Kleisiaris
Community Nursing, Technological Educational
Institute of Crete, Greece
Dr. Smriti Arora
Rufaida College of Nursing, Jamia Hamdard,
Hamdard Nagar, New Delhi, India
Dr. Sutapa Agrawal
South Asia Network for Chronic Disease, Public
Health Foundation of India, Gurgaon (Haryana),
India
Dr. S. Vijayalakshmi
Vignesh Nursing College, Kizhanaikarai,
Tiruvannamalai,
India
Dr. Ioanna V. Papathanasiou
Nursing Department, Technological Educational
Institute of Thessaly, Greece
Mrs. Urmila D Bhardwaj
Department of Nursing, Hamdard University,
India
Dr. Sushma Kumari Saini
National Institute of Nursing Education,
PGIMER, Chandigarh, India
Dr. A. Judie
SRM College of nursing, SRM University,
SRM nagar, potheri, (Tamil Nadu), India
Dr. Mala – Thayumanavan
BGS Global Hospital, Kengeri, Bangalore,
India
Stella Sagaya Mary
Matha college of Nursing, Vaanpuram,
Manamadurai, (Tamil Nadu), India
Dr. Ubahara Sahauaraj
Centre for Addiction Medicine, NIMHANS,
Bangalore, India
A. Arvin Babu
Mental Health Nursing Sree Abirami Hospital
and College Of Nursing, Coimbatore, India
Dr. E. Sinu
Kasturba Medical College, Manipal University,
Manipal,
India
Sibin Joy Vayalil
Community Health Nursing Department &
Research Coordinator Lourdes College of
Nursing, India
Dr. Asha P. Shetty
Yenepoya Nursing College; Yenepoya
University, Deralakatte, Mangalore, India
Dr. Arnel Banaga Salgado
RAK Medical and Health Sciences University,
United Arab Emirates
Dr. C. Kanniammal
Meenakshi College of Nursing,
Chennai, India
Dhanpal H.N.
Smt.Nagarathnamma College of Nursing,
Bangalore, India
Dr. H. Juliet Sylvia
Sacred Heart Nursing College, Ultra trust,
Madurai, India
Mr Dinesh Selvam Subramani
Padmashree Institute of Nursing Kommaghatta,
Bangalore, India
Ms. Kripa Angeline A.
Kasturba Gandhi Nursing College, Puducherry,
India
Vahitha. S
College of Nursing, Jawaharlal Institute of Post
Graduate Medical Education & Research,
Puducherry, India

EDITORIAL BOARD MEMBERS
Mr. N. J. Vasudevan
Chitra College of Nursing, Kerala
India
Evangelos C. Fradelos
RN, MSc, State Mental Hospital of Attica
"Daphne", Greece
Dr. Harmeet kaur
Chitkara School of Health Sciences, Chitkara
University, Punjab, India
Dharitri Swain
All India Institute of Medical Sciences
(AIIMS), Bhubaneswar, Sijua (Odisha), India
Ms. Agnes Elizabeth Jose
Father Muller College of Nursing, Kankanady,
Mangalore, Karnataka,India
Mr Shivarajkumar Dandagi
KLE University Institute of Nursing Sciences,
Karnataka, India
Dr. Usha Ukande
Choithram College of Nursing, CH&RC Indore
(M.P.), India
Dr. C. SUSILA
Billroth College Of Nursing, Chennai,
India
Dr. Parimala.K.Samuel
Chitra College of Nursing, Kerala,
India
Dr. Renuka Gugan
Sri Balaji Vidyapeeth, Puducherry,
India
Dr. Usha Sanjeev
Govt. College of Nursing, Kerala,
India
Dr. Rajee Reghunath
Amala College of Nursing, Kerala,
India

From the Editor's Desk
Dear Readers,
We would like to present, with great pleasure, the Second Volume of a new scholarly
journal, International Journal of Nursing Science Practice and Research. This journal is
part of the Applied Sciences, and is devoted to the scope of present nursing issues, from
theoretical aspects to application-dependent studies and the validation of emerging
technologies.
This new journal was planned and established to represent the growing needs of Nursing Science Practice as
an emerging and increasingly vital field, now widely recognized as an integral part of scientific and
technical investigations. Its mission is to become a voice of the Nursing Science community, addressing
researchers andpractitionersinthisarea.
The core vision of International journal of Nursing Science Practice and Research in JournalsPub is to
propagate novel awareness and know-how for the profit of mankind ranging from the academic and
professional research societies to industry practitioners in a range of topics in Plant Nursing in general.
JournalsPub acts as a pathfinder for the scientific community to published their papers at excellently, well-
time&successfully.
International Journal of Nursing Science Practice and Research focuses on original high-quality research
in the realm of Nursing theory and practice, Nurse education, Emergency nursing, Geriatric nursing,
Communityhealthnursing and Intellectualdisabilitynursing.
The Journal is intended as a forum for practitioners and researchers to share the techniques of Nursing and
solutionsinthearea.
Many scientists and researchers have contributed to the creation and the success of the Nursing community.
We are very thankful to everybody within that community who supported the idea of creating an innovative
platform. We are certain that this issue will be followed by many others, reporting new developments in the
fieldofNursing.
This issue would not have been possible without the great support of the Editorial Board members, and we
would like to express our sincere thanks to all of them. We would also like to express our gratitude to the
editorialstaffofJournalsPub,who supported us ateverystageoftheproject.
It is our hope that this fine collection of articles will be a valuable resource for Nursing readers and will
stimulatefurtherresearchintothevibrantareaofNursing.
PuneetMehrotra
ManagingDirector

1. Is Sexual Harassment of Nurses an Ice Berg in India? Are Our Student Nurses and
Nurses Free From Harassment?
Meena Ganapathy 1
2. Effectiveness of Positive Family Interactions Module on the Expressed Emotion of the Caregivers and
Relapse of Patients with Schizophrenia in a Psychiatric In-Patient Facility: A Pilot Study Report
Agnes Elizabeth Jose 11
3. Exercises and Quality of Sleep Among Elderly
D. Jose, A. Prabhakar, N. Meenakshi Sundaram 19
4. A Study to Assess the Effectiveness of Self-Instructional Module (SIM) on Knowledge Regarding Adverse
Effects of Selected Antipsychotic Drugs among Interns in Selected Nursing School's of Belgaum
Mahesh C. Gadag 29
5. Identification of Triggering Factors of Migraine
Saniya Jose, Susan Kumar, Thomas Mathew 33
6. Effectiveness of Helfer Skin Tap Technique on Pain During IM Injection
A. Kripa, M. Anbhu, K. Renuka 41
Contents

IJNSPR (2016) 1-10 © JournalsPub 2016. All Rights Reserved Page 1
International Journal of Nursing Science Practice and Research
eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
Is Sexual Harassment of Nurses an Ice Berg in India? Are Our
Student Nurses and Nurses Free From Harassment?
Meena Ganapathy*
Department of Nursing, Maharshi Karve Stree Shikshan Samstha, Smt. Bakul Tambat Institute of Nursing
Education, Karvenagar, Pune, India
ABSTRACT
The brutal abuse done on Aruna Shanbhaug, a nurse from KEM hospital, Mumbai and on
Nirbhaya, in Delhi and the sexual harassment of student nurses by the School of Nursing by
the owner in Andhra Pradesh highlight the flight of women in India. Sexual harassment is
always a play of unequal power dynamics wanting to crush the weaker. Despite being visible
only at the tip, it is always been there deep rooted from times immemorial. All of us tend to
sweep it under the carpet pretending the failure to see it will be equivalent to non – existence.
But the truth is it is there everywhere at transit to transport, public places, educational
institutions and work place. The potential harassers are free to do so because we tend to look
at it as an individual issue and shame the victim rather than the system. Nursing being the
profession with 90% of its members being women is the most vulnerable profession. Nurses
need to be aware of this issue, and act collectively to prevent this being done on the innocent,
ill-informed victims.
Keywords: harassment, workplace
INTRODUCTION
Sexual harassment at education institutions
or at work place or at public spaces or
anywhere is a violation of human right. It
is an attack on the person’s privacy and
dignity. (International Labor Organization
and Forum for Women Law and
Development 2004).[1]
Throughout the world, unwanted sexual
attention of men is a common problem
faced by girls, boys, women and men too.
This experience is universal -
transcending, caste, creed, socio economic,
educational status, nations and cultural
identities. The most common loss faced by
the girls and women due to this problem is
loss of educational opportunity and loss of
employment (Phoebe M., & James EG.).[2]
Many at times the perpetrators are those
who are in regular contact with the victim.
The victim chooses to do nothing or just
pretend as if they have not seen, faced or
experienced harassment. The victim is
always a subordinate where there is power
dynamics involved. Sexual harassment is
reported where there is uneven power
(Menon et.al, 2008, Chen et.al, 2009 &
Lee et al., 2011).[3]
Nurses and nursing students are highly
vulnerable as they are in a dependent
profession. Workers in the service
industries are often sexually harassed by
their customer, seniors and colleagues.
Among those victims, workers in retail,
catering, health care and nursing industries
have been regarded as vulnerable group
(China. Daily Asia, 2013).[4]

eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
Effectiveness of Positive Family Interactions Module on the
Expressed Emotion of the Caregivers and Relapse of Patients
with Schizophrenia in a Psychiatric In-Patient Facility: A Pilot
Study Report
Agnes Elizabeth Jose*
Department of Mental Health Nursing, Father Muller College of Nursing, Mangalore, Karnataka, India
ABSTRACT
This randomized pilot study was aimed to determine whether the administration of the family
intervention ‘Positive Family Interactions Module’ will be feasible and effective in reducing
the expressed emotion of caregivers and relapse of patients with schizophrenia. The pilot
study tested the trial design, and ability to recruit and deliver the intervention. Drop-out rates
were assessed. The completion and acceptability of the intervention were investigated. The
study also enlightened a sample measurement power calculation for an upcoming substantive
randomized controlled trial. Five caregivers and their patients each were randomly assigned
to Positive Family Interactions Module (experimental) group or Treatment As Usual
(control) group. There was a significant reduction in the expressed emotion of the PFIM
group compared to TAU group. All participants had completed the follow up in both the
groups. Significant improvements over time were observed in both the groups of patients.
Positive feasibility results suggest that the study should be conducted on a larger sample size.
Keywords: caregivers, family intervention, positive family interactions, schizophrenia,
relapse
INTRODUCTION
Schizophrenia is a serious debilitating
psychological disorder which not only
influences the lives of those affected but
also his family.[1]
Schizophrenia affects
about 7 per thousand of the adult
population, mostly in the age group 15–35
years. Though the incidence is low (3–
10,000), the prevalence is high due to
chronicity. It affects about 24 million
people worldwide. About 4.3–8.7 million
people in India suffer from
schizophrenia.[2]
Unlike in the West where
in many cases the expansive network of
professionals act as a surrogate family, in
India family remain the single most
important source of care for the patients
with chronic mental illnesses. It is both by
choice and compulsion due to lack of
facilities.[3]
As schizophrenia tends to become chronic
the functional decline leads to loss of
social functioning, alters communication
patterns in the family, leads to
occupational difficulties and puts a burden
in the family.[1]
The chronic burden of
caregiving to a patient with schizophrenia
is likely to generate negative emotions and
their expression.[4]
Expressed emotion
(EE) comprises critical or emotionally
over-involved attitudes or behaviors
(critical comments, hostility and emotional
over-involvement).[4,5]
With the advent of

eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
Exercises and Quality of Sleep Among Elderly
D. Jose1
*, A.Prabhakar2
, N. Meenakshi Sundaram2
1
Lecturer, Lourdes College of Nursing, Ernakulam, India
2
R.V.S. College of Nursing, Coimbatore, India
ABSTRACT
A quasi experimental pretest – posttest study was done to evaluate whether three different
types of exercises – walking, stretching and a combination of walking and stretching
exercises made any significant difference in quality of sleep of elderly people from selected
old age homes, Kerala. From four different old age homes 100 subjects were selected by
simple random sampling, and assigned 25 subjects each to three experimental groups and
control group. Experimental group I was taught walking exercises; group II stretching
exercises and group III a combination of walking and stretching exercises and made them to
practice the exercises 5 days a week for 20 minutes for one month. Data was collected using
modified Pittsburgh Sleep Quality Index scale by interview technique. The analytical
findings revealed that the overall sleep quality was poor in all the groups before the
intervention and after the intervention 76 – 80% subjects in the experimental groups got
good quality of sleep while no change was observed in control group. The mean overall
sleep quality score of experimental groups markedly improved from 14.44 to 5.52 after the
intervention which indicated good overall quality of sleep, meanwhile the control group
mean sleep scores remained the same. This study concluded that walking and stretching
exercises had a great impact on the quality of sleep of elderly in old age homes. So it is
recommended that some form of exercise or physical activity can improve quality of sleep in
elderly.
Keywords: elderly, quality of sleep, stretching exercises, walking exercises
INTROUCTION
The world population is rapidly ageing and
it is projected that in the next few decades
most of the elderly would be in the
developing countries. Between 2000 and
2050, the proportion of the world's
population over 60 years will double from
about 11% to 22%. The absolute number
of people aged 60 years and over is
expected to increase from 605 million to 2
billion over the same period (WHO, 2012).
India has around 100 million elderly at
present and the number is expected to
increase to 323 million, constituting 20 per
cent of the total population, by 2050,
according to the report jointly brought out
by United Nations Population Fund
(UNFPA) and Help Age International.
Ageing results in many morphological,
physiological as well as psychological
changes, those affect the social life of
senior citizen. The biological changes start
occurring which outwardly may show as
tiredness, breathlessness, joint and muscle
aches, forgetfulness, decreased appetite,
sleep, sight and hearing. Unlike adults,
who usually suffer from a single disease at
a given time, older people generally get
multiple ailments simultaneously.
Sleep disorders are common among
elderly people, affecting about 50%

eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
A Study to Assess the Effectiveness of Self-Instructional Module
(SIM) on Knowledge Regarding Adverse Effects of Selected
Antipsychotic Drugs among Interns in Selected Nursing School’s
of Belgaum
Mahesh C. Gadag*
Department of Mental Health Nursing, KLE’s Institute of Nursing Sciences, Hubballi, Karnataka, India
ABSTRACT
A study to assess the effectiveness of self-instructional module (SIM) on knowledge regarding
adverse effects of selected antipsychotic drugs among interns in selected nursing school’s of
Belgaum, was carried out for partial fulfillment of the requirement for the award of Master of
the Degree of Nursing at KLE University Institute of Nursing Science Belgaum. The
objectives of the study were, to assess the level of the knowledge regarding adverse effects of
antipsychotic drugs among interns, to evaluate the effectiveness of Self Instructional Module
on knowledge regarding adverse effects of antipsychotic drugs among interns, to associate
the level of the knowledge regarding adverse effects of antipsychotic drugs among interns.
One group Pretest Posttest design was used which included 60 nursing interns at selected
schools of Belgaum. Nonprobability convenient sampling technique. The tool was self-
structured knowledge questionnaire. The technique adopted was self-reporting. Majority of
the subjects: 81.66% were from age group of 22-24 years, 65% were male and 35% were
female. 46.66% were from Christian community, 43.33% were working in psychiatry ward,
and 41.66% were secured 1st class results in previous academic year. 21.66% of subjects
were having good knowledge, 58.33% having average knowledge and 20% subjects having
poor knowledge, but in post test scores 86.66% of subjects were having good knowledge and
13.33% of subjects having average knowledge score. The self-instructional module
significantly brought out their improvement in the knowledge regarding adverse effects of
antipsychotic drugs among interns in selected schools of nursing at Belgaum.
Keywords: antipsychotics, interns, knowledge, SIM
INTRODUCTION
Medicines now not only treat and cure
diseases that were untreatable just a few
years ago, they aid in the early diagnosis
of disease; prevent life-threatening
illnesses; relieve pain and suffering; and
allow people with terminal illnesses to live
more comfortably during their last days.[1]
Psychiatric medications treat mental
disorders. Sometimes called psychotropic
or psychotherapeutic medications, they
have changed the lives of people with
mental disorders for the better. Many
people with mental disorders live fulfilling
lives with the help of these medications.
Without them, people with mental
disorders might suffer serious and
disabling symptoms.[2]
An antipsychotic (or neuroleptic) is a
psychiatric medication primarily used to
manage psychosis (e.g. delusions or
hallucinations), particularly in
schizophrenia and bipolar disorder. The

IJNSR (2016) 33-40 © JournalsPub 2016. All Rights Reserved Page 33
eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
Identification of Triggering Factors of Migraine
Saniya Jose1*
, Susan Kumar2
, Thomas Mathew3
1
Lourdes College of Nursing, Ernakulam, Kerala, India
2
St. Johns College of Nursing, Bangalore, India
3
St. Johns Medical College, Bangalore, India
ABSTRACT
The most common primary headaches are tension-type headache and migraine.
Migraine headaches may take place due to various triggering factors. One or more
triggering factors can be identified in a migraine patient. The important triggers are stress,
weather changes, fatigue, food and lack of sleep. The objective of the study was to identify
the triggering factors of migraine among patients. Descriptive design was selected for this
study. A sample of 200 patients with migraine attending the Neurology outpatient department
of St. Johns medical college Bangalore was taken using purposive sampling technique. In
order to identify the triggering factors of migraine, a structured questionnaire was used. The
result shows that the commonest triggering factors of migraine were stress (81%), disturbed
sleep (71.5%), loud noise (69.5%) and sunlight (64.5%). The 74.7% of women reported of
passive smoking as a major triggering factor for their migraine.
Keywords: migraine, passive smoking, triggering factors
INTRODUCTION
Migraine is a type of primary headache
which can cause lots of disabilities. The
world Health Organisation (WHO) has
identified migraine among the world’s top
20 leading cause of disability.[1,2]
Based on
the large epidemiological studies from
around the world, the prevalence of
migraine was about 18% in women and
6% in men and the incidence is about 5–
25 out of 100 people.[3–6]
Migraine has no respect for age. It may
affect young children as well as elderly
people. However as general rule, it occurs
in early adult life and subsides after the
age of 45. Those who are suffering with
migraine report excessive sensitivity to
bright light (sunlight), loud noise, stress
and lack of sleep. The factors which
precipitate or aggravate migraine are
called as the triggering factors. The
triggering factors may be of different
types such as; Behavioural (e.g., fasting,
stress), environmental (e.g., bright light,
odour, smoke), dietary (e.g., alcohol,
chocolate, cheese), hormonal (e.g.,
menstruation).
The frequency and severity of migraine
though varies from person to person.
Although there is no permanent cure, one
can reduce the attacks and reduce the
severity of pain, by making certain
changes in the life style.
The triggering factors of migraine may
differ from individual to individual. The
recognition the triggering factors of
migraine is very important because
avoidance from these factors may lessen
the frequency and the severity of the
attacks. Understanding the link between

International Journal of Nursing Science Practice & Research
eISSN: 2455-6351
Vol. 2: Issue 2
www.journalspub.com
Effectiveness of Helfer Skin Tap Technique on Pain During IM
Injection
A. Kripa*, M. Anbhu, K. Renuka
Medical and Surgical Nursing Dept, Kasturba Gandhi Nursing College, Puducherry, India
ABSTRACT
Materials and Methods: Quantitative approach was used by the investigator to evaluate the
objectives of the study. True Experimental research design with two group Pre-test and Post-
test only design was selected to achieve the objectives and to fulfill the need for the study. The
study was conducted in the general ward of MGMC&RI. The sample selected for the study
were 80 patients, 40 in each group (control & experimental). With the help of modified
numerical scale is to assess the pain experience by patient during administering the IM
injection. Result: In pretest out of 40 subjects in experimental group 12(30%) had mild pain
and 25(62.5%) had moderate pain and 03 (7.5%) had severe pain. In control group 02(05%)
had mild level of pain and 32(80%) had moderate level of pain and 06 (15%) had severe
pain. In posttest out of 40 subjects in experimental group 14(35%) had no pain and 24(60%)
had mild pain and 2(5%) had moderate pain and. In control group 01(25%) had mild level of
pain and 35(87.5%) had moderate level of pain and 04 (10%) had severe pain. The mean,
standard deviation of experimental group during pre-test, were 4.4 and 1.48 respectively. In
Post-test, the values were Mean 1.48 and Standard deviation 1.32.which reveals that there
was a significant reduction in the level of pain by using during IM injection. Conclusion:
Subjects in the experimental group expressed more satisfaction about the Helfer skin tap
technique in relieving pain. This study proves that Helfer skin tap technique was effective in
reduction of the level of pain during IM injection.
Keywords: effectiveness, Helfer skin tap technique, IM injection
INTRODUCTION
Comfort is an important need and ensuring
a patient’s comfort is a major nursing
responsibility. Health interventions can be
undertaken in the basis of customs and
habits that practitioner no longer critically
question. The term custom and practice is
commonly used to describe this
phenomenon of practicing health care
interventions based on customs and habits.
In the Nursing and Medical Practice. IM
injection is one of the most frequently
procedures done almost every day. It is
fact that any IM injection will cause pain
at the site of injection (i.e). Pain is evident
when administering IM injection. [1]
In India a survey found that 96% of all
injection given by private doctors was
antibiotics, vitamins, analgesics. The
conservative estimation of the average no
of injections range from 0.9-8.5 per
person.[2]
Helfer skin tap technique offers a painless
injection experience. In this technique
rhythmic tapping before and after injection
keeps the muscle relaxed and simulated
large diameter fibers. It provides a

International journal of nursing science practice and research vol 2 issue 2

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International journal of nursing science practice and research vol 2 issue 2