Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and global health concern. COPD self care knowledge is a cornerstone for self-management of chronic illness. The objective of this study was to find out the level of knowledge on self care among COPD patients. A descriptive, cross sectional design and purposive sampling was applied in which 182 patients were interviewed by using semi-structure interviews schedule at Chitwan Medical College, Teaching Hospital, Bharatpur. Data was analyzed by using SPSS and descriptive and inferential test was applied. The study findings revealed that 36.8% of the respondents were between age group 61-70 years, 54.4% respondents were male, 59.9% were from Chitwan district, majority of the respondents (62.1%) were outpatient, 48.4% had a history of COPD more than 5 years, 83.2%were hospitalized 1-2 times in last year, 63.2% had no history of COPD in family members and all respondents got information from health personnel. Highest percentage (75) of mean score on smoking cessation and lowest (10) on weight monitoring. Most of all respondents (90.7%) had poor level of knowledge on self care of COPD. The respondents’ level of knowledge on self care is statistically significant with family history (p=0.048), educational status (p=0.000), and types of patient (p=0.017).So, there should be need of health education program for COPD patients about self care to improve knowledge. DOI: http://dx.doi.org/10.3126/jcmc.v4i3.11938Journal of Chitwan Medical College 2014; 4(3):34-37

Maternity incentive schemes were to encourage mothers to use skilled birth attendance for the best prevention of maternal and child death where as the pregnant women should have access to high quality prenatal care which, they can afford and where, they are treated with respect. The objective of the study was to determine the knowledge and utilization of maternal incentives scheme on delivery services at rural area of Nepal. This study was cross-sectional descriptive in nature and Study was conducted in Panchkhal VDC, Kavre district of Nepal.The numbers of married women of reproductive age group were the study population. The sample size was taken as 96. Most of the respondent had primary education (38.5%) and illiterate (15.6%). Highest mobilization of sources which provided throughout the health institute disseminates the MIS information During the study seventy nine mothers went to hospital for treatment. Utilization of incentive helps to change the delivery behavior (practice) of women (78%) within the hospital services by the skilled birth attendants. The 54.2% were not getting money (private hospital) for delivery and 13.5% respondents used money in nutrition and transport, 11.5% used in medicine and 1.0% respondent didn't spend money. Low income and poor women (63%) have been more benefited from the incentive scheme followed by Janajati (12.5%), Dalit (12.5%) and rural women (9.4%) respectively. Importance of maternity incentive scheme (MIS) on safe delivery services (SDS) needs to be disseminated in rural community through integrated health education program. Most of the respondents reported that only incentive is not the matter of utilization of hospital services, but the issue of mother and child health.

Adolescence is the period in human development during which several dramatic changes at biological, social, psychological and cognitive levels take place. The objective of this study was to find out psychosocial problems among school children of working and non-working mothers. A descriptive comparative research design and Probability Stratified Random sampling technique was applied in which 120 (60 working and 60 non working mothers') school students of grade 9 and 10 selected from two Government Higher Secondary Schools of Bharatpur. Structured questionnaire and Youth Pediatric Symptoms Checklist-17 (YPSC-17) were administered. Data was analyzed by using IBM SPSS version 20 and Mean, Standard Deviation, t-test and chi-square test were applied. This study showed that school children of non working mothers' (11.7%) had slightly more psychosocial problems than working mothers' (8.3%). Male respondents of non working mothers experienced more psychosocial problems (29.4 %) than female (4.7%). Prevalence of psychosocial problems was found among school children of both working and non working mothers but there is no association between the psychosocial problems and employment status of mothers. Thus maternal employment status is not the exclusive reason behind the development of psychosocial problems among school children.

INTRODUCTION: Distress is a serious problem to nurses, the deepest source of distress that nurse’s experience has been arisen because of the variation between nurse’s values and reality of daily nursing practice. Moral distress referred to the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress has a deleterious effect on patients, nurses, and organizations which results in decreased job satisfaction, increased turnover, and withdrawal from a job, and developing physical and psychological symptoms. The aim of this study is to assess the moral distress among the nurses in Chitwan Medical College Teaching Hospital. MATERIALS AND METHODS: A descriptive, cross-sectional research design was conducted among 114 nurses of Chitwan Medical College Teaching Hospital by use probability, stratified random sampling technique. Data was collected by using Standard Hamric Modified Distress Scale-Revised (MDS-R). RESULTS: The study finding revealed that majority of nurses (82.5%) had mild moral distress and 17.5% had severe moral distress. The father’s occupation was significantly associated with moral distress (p=0.035). Interestingly, a statically significant association was observed between moral distress and respondents who were utilizing facilities of government health insurance (p=0.013). CONCLUSIONS: Nearly one fifth of the nurses have severe moral distress which is less in count but its effects may be severe. Hence special program needs to be organized by hospital admission for nurses to minimize the moral distress.

Background: The family member is an important support system in the care of patient with chronic mental illness. The caregivers experience from a number of significant stresses and burden and need concern from the mental health professionals. The objective of the study was to assess the extent of burden and coping strategies among caregivers of mentally-ill patients. Methods: Descriptive cross-sectional study design was used among 102 caregivers of mentally ill patients admitted in Psychiatric ward of Chitwan Medical College, Teaching Hospital. Non-probability consecutive sampling technique was used to select the sample. Ethical approval was taken from the Institutional Review Committee. Data were collected from 27 January 2020 to 29 May 2020 using a structured interview schedule and record review. Data was analyzed using Statistical Package for Social Sciences version 20 and analyzed by using descriptive statistics and inferential statistics. Results: Among 102 caregivers, it was found that 47.1% caregivers perceived moderate to severe burden, 41.2% of the caregivers experienced mild to moderate and 11.8% experienced minimal burden. The highest median percentage of caregivers reported financial burden (50%) where 41.66% reported burden in the relationship. The most frequently used strategies were use of informational support (62.5%), venting (62.5%), positive reframing (62.5%), acceptance (62.5%), and religion (62.5%). Conclusions: The highest percentage of caregivers experienced moderate to severe burden. So, mental health professionals should develop training programs that include counseling to support both patients and family caregivers to reduce the family burden and improving coping skills.