Publications by authors named "Sumina Shrestha"

7 Publications

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Caring self-efficacy of direct care workers in residential aged care settings: A mixed methods scoping review.

Geriatr Nurs 2021 Nov-Dec;42(6):1429-1445. Epub 2021 Oct 11.

Australian Institute for Primary Care & Ageing, La Trobe University, Bundoora, VIC, 3086, Australia; School of Health, Federation University Australia, Berwick, Victoria, Australia; Department of Non-communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh; Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

The caring self-efficacy of direct care workers in residential aged care has been explored in the literature mostly as a predictor rather than the focus of interest. This scoping review aimed to provide an overview of the existing literature on aged care workers' caring self-efficacy and factors that influence it. A systematic search was performed in six electronic databases. All primary studies were included. A total of 41 studies met the inclusion criteria. Caring self-efficacy was most often described by aged care workers as their capacity to deal with difficult situations. The self-efficacy scores of direct care workers were high across studies. Self-efficacy was positively influenced by access to resources, relationships with residents and their families, the support of supervisors and co-workers, job satisfaction, and training opportunities, and negatively affected by work pressure and burnout. Findings indicate possible avenues for intervention to improve direct care workers' self-efficacy in aged care.
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http://dx.doi.org/10.1016/j.gerinurse.2021.09.014DOI Listing
October 2021

The effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis.

World J Emerg Surg 2021 07 13;16(1):38. Epub 2021 Jul 13.

School of Nursing & Midwifery, La Trobe University, 1st floor, HSB 1, La Trobe University, Bundoora, VIC, 3086, Australia.

Background: Traumatic injury remains the leading cause of death, with more than five million deaths every year. Little is known about the comparative effectiveness in reducing mortality of trauma care systems at different stages of development. The objective of this study was to review the literature and examine differences in mortality associated with different stages of trauma system development.

Method: A systematic review of peer-reviewed population-based studies retrieved from MEDLINE, EMBASE, and CINAHL. Additional studies were identified from references of articles, through database searching, and author lists. Articles written in English and published between 2000 and 2020 were included. Selection of studies, data extraction, and quality assessment of the included studies were performed by two independent reviewers. The results were reported as odds ratio (OR) with 95 % confidence intervals (CI).

Results: A total of 52 studies with a combined 1,106,431 traumatic injury patients were included for quantitative analysis. The overall mortality rate was 6.77% (n = 74,930). When patients were treated in a non-trauma centre compared to a trauma centre, the pooled statistical odds of mortality were reduced (OR 0.74 [95% CI 0.69-0.79]; p < 0.001). When patients were treated in a non-trauma system compared to a trauma system the odds of mortality rates increased (OR 1.17 [95% CI 1.10-1.24]; p < 0.001). When patients were treated in a post-implementation/initial system compared to a mature system, odds of mortality were significantly higher (OR 1.46 [95% CI 1.37-1.55]; p < 0.001).

Conclusion: The present study highlights that the survival of traumatic injured patients varies according to the stage of trauma system development in which the patient was treated. The analysis indicates a significant reduction in mortality following the introduction of the trauma system which is further enhanced as the system matures. These results provide evidence to support efforts to, firstly, implement trauma systems in countries currently without and, secondly, to enhance existing systems by investing in system development.

Systematic Review Registration Number: PROSPERO CRD42019142842 .
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http://dx.doi.org/10.1186/s13017-021-00381-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278750PMC
July 2021

Effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis protocol.

BMJ Open 2021 06 3;11(6):e047439. Epub 2021 Jun 3.

School of Nursing and Midwifery, La Trobe University-Bundoora Campus, Melbourne, Victoria, Australia.

Introduction: The introduction of trauma systems that began in the 1970s resulted in improved trauma care and a decreased rate of morbidity and mortality of trauma patients. Worldwide, little is known about the effectiveness of trauma care system at different stages of development, from establishing a trauma centre, to implementing a trauma system and as trauma systems mature. The objective of this study is to extract and analyse data from research that evaluates mortality rates according to different stages of trauma system development globally.

Methods And Analysis: The proposed review will comply with the checklist of the 'Preferred reporting items for systematic review and meta-analysis'. In this review, only peer-reviewed articles written in English, human-related studies and published between January 2000 and December 2020 will be included. Articles will be retrieved from MEDLINE, EMBASE and CINAHL. Additional articles will be identified from other sources such as references of included articles and author lists. Two independent authors will assess the eligibility of studies as well as critically appraise and assess the methodological quality of all included studies using the Cochrane Risk of Bias for Non-randomised Studies of Interventions tool. Two independent authors will extract the data to minimise errors and bias during the process of data extraction using an extraction tool developed by the authors. For analysis calculation, effect sizes will be expressed as risk ratios or ORs for dichotomous data or weighted (or standardised) mean differences and 95% CIs for continuous data in this systematic review.

Ethics And Dissemination: This systematic review will use secondary data only, therefore, research ethics approval is not required. The results from this study will be submitted to a peer-review journal for publication and we will present our findings at national and international conferences.

Prospero Registration Number: CRD42019142842.
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http://dx.doi.org/10.1136/bmjopen-2020-047439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183269PMC
June 2021

Self-efficacy of direct care workers providing care to older people in residential aged care settings: a scoping review protocol.

Syst Rev 2021 04 10;10(1):105. Epub 2021 Apr 10.

Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, Australia.

Background: Self-efficacy is developed through a person's interaction with his/her physical and social environment. Self-efficacy in caring is an essential attribute of care workers to develop a positive attitude towards their clients, improve work performance, and enhance job satisfaction. Care workers' self-efficacy may vary according to the context in which the care is being provided. Aged care is a multidimensional and challenging setting, and characteristics of aged care services are different from those of acute care services. The objective of this review is to give an overview of the self-efficacy of residential aged care workers in caring for older people and factors influencing their self-efficacy.

Methods: The protocol for this review is based on the Joanna Briggs Institute Reviewer's Manual for Scoping Review. A systematic search of the literature on electronic databases MEDLINE, PsycINFO, CINAHL, AgeLine, SCOPUS, and ProQuest Dissertations and Theses Global will be carried out using predefined search terms to identify relevant studies. This review will include studies that examined the self-efficacy of direct care workers in caring for older people living in residential aged care facilities. All primary studies irrespective of the study design will be included. Studies conducted to develop measures or studies with informal care workers or students as study participants will not be considered. Two reviewers will independently conduct title and abstract screening, full-text screening, and data charting. A third reviewer will resolve discrepancies, while the final decision for conflicting studies will be made by consensus within the review team. Descriptive statistics will be utilized to analyze the quantitative findings, and the result will be presented in narrative form accompanied by tables and charts. Content analysis will be carried to analyze the qualitative findings and will be presented in narrative form supported by illustrative quotations.

Discussion: This study will be an important source of knowledge to policymakers and aged care providers to understand the self-efficacy of aged care workers to support and enhance their self-efficacy and thereby improve their caring behaviors towards their clients.

Scoping Review Registration: Joanna Briggs Institute Systematic Review Register with the title "A scoping review of factors influencing caring efficacy of direct care workers providing care to older people".
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http://dx.doi.org/10.1186/s13643-021-01655-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035725PMC
April 2021

Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case-control study.

BMJ Open 2017 Aug 28;7(8):e017084. Epub 2017 Aug 28.

Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Background: Malnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country.

Objective: To assess the determinants of SAM among children aged 6-59 months in the Bara district of Nepal.

Setting: A community-based case-control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal.

Participants: A random sample of 292 children aged 6-59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study.

Results: The prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother's age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother's educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM.

Conclusion: The mother's age at birth, birth interval, socioeconomic status, father's educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition.
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http://dx.doi.org/10.1136/bmjopen-2017-017084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5724075PMC
August 2017

Domestic violence among antenatal attendees in a Kathmandu hospital and its associated factors: a cross-sectional study.

BMC Pregnancy Childbirth 2016 11 21;16(1):360. Epub 2016 Nov 21.

Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Background: Domestic violence during pregnancy is a public health problem which violates human rights and causes an adverse effect on both maternal and fetal health. The objectives of the study were to assess the prevalence of domestic violence among the pregnant women attending the antenatal clinic, to explore the associated factors, and to identify the perpetrators of domestic violence.

Methods: A descriptive cross-sectional study was conducted among 404 pregnant women in their third trimester of pregnancy. Convenient sampling was used to select the study population. Data collection tools consisted of questionnaires on socio-demographic characteristics of the woman and her spouse, social support, and the woman's attitude towards domestic violence, along with her experiences of psychological, physical, and sexual violence. Domestic violence was assessed using a questionnaire adapted from a World Health Organization multi-country study on women's health and life experiences. Relationships between domestic violence and the various factors were determined by bivariate analysis using a chi-square test. Binary logistic regression with 95% confidence interval and adjusted odds ratio were then applied to assess the factors independently associated with domestic violence.

Results: More than one-quarter (27.2%) of the pregnant women had experienced some form of violence. The most common form of violence was sexual violence (17.3%), followed by psychological violence (16.6%) and physical violence (3.2%). Husbands within the age group 25-34 years (AOR = 0.38), women married for 2-5 years (AOR = 0.42) and who had one or two children (AOR = 0.32) were negatively associated with domestic violence. Whereas the presence of husband's controlling behavior (AOR = 1.88) and experience of violence before the current pregnancy (AOR = 24.55) increased the odds of experiencing violence during pregnancy. The husband was the major perpetrator in all type of violence.

Conclusions: Domestic violence is common among pregnant women attending an antenatal clinic. It indicates a need for routine screening during antenatal visits to identify women experiencing violence and thus provide support services, thereby preventing them from adverse health consequences.
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http://dx.doi.org/10.1186/s12884-016-1166-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117509PMC
November 2016

Predictors of incompletion of immunization among children residing in the slums of Kathmandu valley, Nepal: a case-control study.

BMC Public Health 2016 09 13;16:970. Epub 2016 Sep 13.

Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Background: Immunization is one of the most effective health interventions averting an estimated 2-3 million deaths every year. In Nepal, as in most low-income countries, infants are immunized with standard WHO recommended vaccines. However, 16.4 % of children did not receive complete immunization by 12 months of age in Nepal in 2011. Studies from different parts of the world showed that incomplete immunization is even higher in slums. The objective of this study was to identify the predictors of incompletion of immunization among children aged 12-23 months living in the slums of Kathmandu Valley, Nepal.

Methods: The unmatched case-control study was conducted in 22 randomly selected slums of Kathmandu Valley. The sampling frame was first identified by complete enumeration of entire households of the study area from which 59 incompletely immunized children as cases and 177 completely immunized children as controls were chosen randomly in 1:3 ratio. Data were collected from the primary caretakers of the children. Backward logistic regression with 95 % confidence interval and adjusted odds ratio (AOR) were applied to assess the factors independently associated with incomplete immunization.

Result: Twenty-six percent of the children were incompletely vaccinated. The coverage of BCG vaccine was 95.0 % while it was 80.5 % for measles vaccine. The significant predictors of incomplete immunization were the home delivery of a child, the family residing on rent, a primary caretaker with poor knowledge about the schedule of vaccination and negative perception towards vaccinating a sick child, conflicting priorities, and development of abscess following immunization.

Conclusion: Reduction of abscess formation rate can be a potential way to improve immunization rates. Community health volunteers should increase their follow-up on children born at home and those living in rent. Health institutions and volunteers should be influential in creating awareness about immunization, its schedule, and post-vaccination side effects.
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http://dx.doi.org/10.1186/s12889-016-3651-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5020516PMC
September 2016
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