Barriers and outcomes of therapeutic communication between nurses and patients in Africa: a scoping review.

BACKGROUND: Therapeutic communication (TC) promotes effective patient care, emotional wellbeing, and improves patient outcomes. The purpose of this review was to synthesise evidence on barriers and outcomes of TC between nurses and patients in Africa and to inform future studies and systematic reviews. METHODS: Search for the records was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Results and findings from published studies and grey literature were included. A total of 16 articles met the eligibility criteria and were included in the review. This scoping review followed the guidelines by Askey and O'Malley. RESULTS: Barriers associated with TC were grouped under five main themes: sociodemographic factors, patient-related factors, nurse-related factors, environmental and health service-related. Age, and religious beliefs were the main sociodemographic factors that hindered TC while stress and inadequate knowledge and skills were identified among the nurse-related barriers to TC. Extreme weather conditions and mosquito infestation were environmental factors while lack of access to TC educational programmes on TC was a health service-related factor that interfered with TC. Both positive and negative outcomes of TC were also identified. CONCLUSION: Continuous professional development on TC is necessary to improve nurses' attitudes and update their skills to enable them to render culturally competent nursing care to patients.

Clinical preceptorship in Ghana in the era of COVID-19 pandemic: an interventional study.

BACKGROUND: Innovations in clinical nursing education are critical in enhancing the experiences of students, especially in the era of coronavirus pandemic. This study aimed at investigating nurse preceptors' perceptions of use, intention to use and self-efficacy towards digital technology in preceptorship in the Cape Coast Metropolis of Ghana. METHODS: A concurrent type of mixed-methods design with a non-randomised interventional study using three-phase multi-methods technique was conducted among nurse preceptors in the Cape Coast Metropolis in the Central Region of Ghana. Forty-five nurse preceptors participated in a pre and post training intervention while seven were purposively selected for the qualitative interview. Complimentarity method of triangulation was used in the analysis. The quantitative data were analysed with STATA version 16 and presented using frequencies, percentages, means with standard deviations and McNemar's test while qualitative data were analysed using the six steps approach to qualitative data analysis by Braun and Clarke. RESULTS: Perceived usefulness statement "using technology will improve clinical teaching" increased from 19 (42.22%) at baseline to 44 (97.78%) post intervention. Perceived ease of using technology statement "I would find it easy to get this technology to do what I want it to do" also increased from 36 (80.00%) to 41 (91.11%) post intervention. Self-efficacy increased from 40 (88.89%) to 43 (95.56%) after the intervention. There was a statistically significant difference between pre-training and post-training scores regarding tablet (p = 0.016) and experience with online library resources (p = 0.039). The qualitative results yielded three themes, namely: strengths of using technology; constraints in the learning environment; and future of technological approach to clinical teaching. CONCLUSIONS: The training intervention improved participants intentions, self-efficacy, perceived use and perceived ease of use of technology. However, there are constraints in the clinical learning environment including students and preceptor-related factors, and institutional factors that needs to be addressed as part of efforts to implement technology in clinical teaching in this era of COVID-19 pandemic and beyond.

Self-management needs, strategies and support for sickle cell disease in developing countries: a scoping review protocol.

INTRODUCTION: Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies, and there is a notable dearth of evidence synthesis on SCD self-management in developing countries. This scoping review aims to identify and map self-management needs of individuals living with SCD, the strategies they employed to meet those needs, and the support systems available to them. METHODS AND ANALYSIS: The review will be conducted following the Arksey and O'Malley's (2005) 29 framework to comprehensively examine the landscape of SCD self-management research. Searches will be performed in PubMed, Scopus, Embase and Dimensions AI, with additional searches in other databases and grey literature. Indexed literature published in English from inception to January 2024 will be included. Reference list from included studies will also be searched manually. Two teams will be constituted to independently screen titles, abstracts and full text against the eligible criteria. Data will be extracted from included studies onto a customised data extraction form. ETHICS AND DISSEMINATION: Ethical approval is not required for this review due to the fact that it synthesises information from available publications. The findings will be disseminated through publication in a peer-reviewed journal. Also, the findings will possibly be presented at relevant international and national conferences. This protocol has already been registered with the Open Science Framework. The study characteristics such as design and setting will be descriptively analysed and presented as graphs, tables and figures. Thematic analysis will also be conducted based on the study objectives and presented as a narrative summary.

The Influence of COVID-19 Pandemic on the Health Seeking Behaviors of Adults Living With Chronic Conditions: A View Through the Health Belief Model.

The COVID-19 pandemic resulted in disruption in every facet of life including health service delivery. This has threatened the attainment of global targets to improve health and wellbeing of all persons. In particular, for persons living with chronic diseases, who require consistent monitoring by health professionals and medication to enhance their health, understanding how the pandemic has disruption their access to health care delivery is critical for interventions aimed at improving health service delivery for all as well as preparedness for future pandemic. This study applied the constructs of the Health Belief Model, to explore the influences of the COVID-19 pandemic on the health seeking behaviors of persons living with chronic diseases. The design was exploratory descriptive. Semi-structured interviews were conducted to collect data among persons living with chronic diseases in the Cape Coast Metropolis of Ghana. Thematic analysis, both inductive and deductive, was conducted to unearth the findings. Awareness of increased susceptibility and risk of a more severe episode if they contracted COVID-19 as a result of the existing chronic diseases was identified. Lack of access to health professionals during the peak of the pandemic as well as the fear of contracting the virus while accessing their regular chronic disease clinic was the main barriers identified. Information in the media served as cues to action for adopting preventive health strategies. Behavior modifications; dietary and lifestyle, self-medication and adoption of COVID-19 related precautions were practiced. Susceptibility to contracting COVID-19 contributed to missed adherence to treatment appointment. The health belief model was a useful framework in exploring the health seeking behavior of the adults living with chronic conditions during the COVID-19 in this study setting. Intensifying targeted education for persons living with chronic diseases will contribute to the adoption of positive health seeking behaviors during future pandemic.

Health service factors affecting the COVID-19 vaccination campaign in a Ghanaian metropolis: A qualitative exploratory study.

OBJECTIVE: The study sought to explore the perspectives of vaccinators on the health system factors that impacted the COVID-19 vaccination campaign. DESIGN: The study employed an exploratory-descriptive qualitative design. Key-informants' interviews were conducted using semi-structured guide to gather the data. Thematic analysis following the steps of Braun and Clark was conducted using ATLAS.ti software. SETTING: The study setting was the Cape Coast Metropolis where the Central Regional Health Directorate is located. The Directorate initiates and implements policy decisions across the region. It is also the only metropolis in the region that recorded about 5970 of the total COVID-19 cases recorded in Ghana. PARTICIPANTS: Eleven vaccinators who had been trained for the COVID-19 vaccination and had participated in the campaign for at least 6 months were purposively sampled through the Regional Public Health Unit. RESULTS: Four themes were derived from the data after analysis; 'vaccine-related issues'; 'staffing issues'; 'organising and planning the campaign' and 'surveillance and response systems'. Subthemes were generated under each major theme. Our results revealed the health service promoted the COVID-19 vaccination campaign through public education and ensured access to COVID-19 vaccines through the use of community outreaches. Also, the health service ensured adequate logistics supply for carrying out the campaign as well as ensured vaccinators were adequately equipped for adverse incidence reporting and management. Dissatisfaction among COVID-19 vaccinators attributed to low remuneration and delays in receiving allowances as well as shortfalls in efforts at securing transportation and a conducive venue for the vaccination exercise also emerged. Other challenges in the vaccination campaign were attributed to poor data entry platforms and limited access to internet facilities. CONCLUSION: This study highlights the health system's strategies and challenges during the COVID-19 vaccination campaign, emphasising the need for critical interventions to prevent low vaccination rates.

Older people's challenges and expectations of healthcare in Ghana: A qualitative study.

BACKGROUND: The increase in the number of elderly persons in developing countries has not had a corresponding increase in social and health care support systems for the elderly. There is a substantial difference in the quality of healthcare received by older people in developing and developed countries. Elderly persons in developing countries including Ghana are increasingly becoming marginalised and isolated. There is, however, limited evidence of healthcare challenges and expectations by elderly persons in Ghana. This study explored healthcare challenges and expectations of elderly persons to inform policy that could lead to improved quality of life for elderly persons in Ghana. MATERIALS AND METHODS: Qualitative exploratory descriptive study design was used in conducting this study. Semi-structured interviews were used in collecting data from 30 participants from three regions in Ghana (10 from each region). Data analysis was carried out through content analysis. RESULTS: Four themes were extracted from data. These themes were: 1. Inadequate information from health workers regarding care of the older person. 2. Queuing frustrations. 3. Financial burden. 4. Focused elderly care demand. CONCLUSION: The elderly in Ghana experience challenges of healthcare which include inadequate information, queuing frustrations and financial burdens. Elderly persons also have expectations of healthcare which include having dedicated professionals and units that will attend to them during their hospital visits. Academic and clinical gerontology experts could collaborate and help improve gerontology knowledge of health workers through workshops and conferences. Improving knowledge of health workers in gerontology may be a positive step towards meeting healthcare expectations of older Ghanaians.

Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana.

INTRODUCTION: There is documented evidence pointing to the fact that there are numerous challenges with postoperative pain (POP) management globally. However, these challenges with POP management are more profound in developing countries. PURPOSE: The purpose of this study is to examine the knowledge, attitude, and practices of nurses concerning POP management in four selected district hospitals in Ghana. METHODOLOGY: A descriptive, cross-sectional survey was employed to evaluate nurse's knowledge, attitude, and practices pertaining to POP management. Multistaged sampling was used to draw the respondents. An adapted version of the Nurses Knowledge and Attitudes Survey Regarding Pain instrument was used to test the knowledge, attitude, and practices of nurses and midwives. Descriptive statistics were used to analyze the data in order to present quantitative descriptions of variables in this study. RESULTS: This study showed that nurses in the four district hospitals had knowledge deficits regarding POP management. Eighty-one representing 48% of nurses had low knowledge on POP management. An overwhelming majority of nurses (97.6%) relied on routinely rendered basic nursing skills to relieve POP and a few used pharmacological interventions. However, nurses had good attitudes toward POP management. CONCLUSIONS: POP is ineffectively managed by nurses in district hospitals in Ghana. Nurses and midwives in Ghana need to adhere to best practices in POP management by increasing their theoretical and practical knowledge, so that there will be tangible positive change in POP management in Ghana. RECOMMENDATIONS: Nurses must be empowered through continuous development programs to keep abreast with changing trends that pertain to POP management.