The Burden and Quality of life of Caregivers of Stroke Survivors with Cognitive Impairment in Selected Healthcare Facilities in Anambra State, Nigeria.

Objective: To determine the burden and quality of life of caregivers of stroke survivors with cognitive impairment in selected healthcare facilities in Anambra State, Nigeria. Methods: This was a cross-sectional survey using the World Health Organization QOL-BREF and Caregiver Strain Index (CSI) as instruments. Descriptive statistics of frequency, percentage counts, mean and standard deviation were used to summarize the socio-demographics. Spearman's ranked order correlation; Mann-Whitney U test assessed the correlation and gender and age difference in QoL and caregiver's burden. Alpha level was set at 0.05. Results: Physical health domain of QOL was slightly moderate (53.29 ± 15.19), psychological health was low (46.33 ± 16.96), social relationship was slightly moderate (51.16 ± 0.31), environmental health was slightly moderate (51.22 ± 15.88), the burden of caregivers was high (6.35 ± 1.29). Conclusion: The quality of life of the caregivers of stroke survivors with cognitive impairment was moderate, and the caregivers' stress was high in the sample of the population studied.

Strengthening Capacity for Prostate Cancer Early Diagnosis in West Africa Amidst the COVID-19 Pandemic: A Realist Approach to Rethinking and Operationalizing the World Health Organization 2017 Guide to Cancer Early Diagnosis.

Two years after SARS-CoV-2 (COVID-19) was declared a global public health emergency, the restoration, at least, to the pre-pandemic level of early diagnostic services for prostate cancer has remained enormously challenging for many health systems, worldwide. This is particularly true of West Africa as the region grapples also with the broader impacts of changing demographics and overly stretched healthcare systems. With the lingering COVID-19 crisis, it is likely that the current trend of late prostate cancer diagnosis in the region will worsen with a concomitant increase in the burden of the disease. There is, therefore, a compelling need for innovative and evidence-based solutions to de-escalate the current situation and forestall the collapse of existing structures supporting early prostate cancer diagnosis in the region. In this viewpoint, we make a case for the operationalization of the World Health Organization (WHO) guide to early cancer diagnosis to strengthen the capacity for early prostate cancer diagnosis in West Africa using a realist approach, drawing on participatory health research and evidence-based co-creation. Ultimately, we demonstrate the potential for developing COVID-19 responsive and context-specific models to optimize patient navigation/journey along the essential steps of the World Health Organization guide to early cancer diagnosis.

Plausible conditions and mechanisms for increasing physical activity behavior in men with prostate cancer using patient education interventions: sequential explanatory mixed studies synthesis.

PURPOSE: This mixed studies synthesis sought to evaluate structured patient education interventions (PEIs) to elucidate relevant conditions and mechanisms for increasing physical activity behavior in men with prostate cancer (PCa). METHODS: Studies that randomized men diagnosed with PCa, assessed PEIs, and reported (1) between-group changes in the outcome measures of exercise self-efficacy, PA level, or patient-centered outcomes (cancer-related fatigue, aerobic fitness, and quality of life) at baseline and post-intervention, and/or (2) men's perceptions of structured PEIs were synthesized. Results from five RCTs reporting data on 895 men and qualitative reports from four studies were respectively and sequentially analyzed with narrative and thematic syntheses. Findings from both syntheses were further integrated using the context-mechanism-outcome configuration (CMO) to elucidate potential "contextual factors" or "conditions" that may support plausible PEI mechanisms. RESULTS: Structured PEIs were associated with a beneficial increase in task self-efficacy, vigorous-intensity PA, minutes/week of resistance exercise, the proportion of men meeting ≥ 150 minutes/week of moderate-vigorous intensity aerobic exercise, and overall PA. No effects were found on patient-centered outcomes. Drawing upon the CMO configuration, the inclusion of a referral process, access to "credible influence" (e.g., involving former patients as program facilitators), and adopting hybrid service delivery are likely critical conditions that may explain the success of PEIs in men with PCa. CONCLUSION: PEIs can increase PA behavior in men with PCa. The likelihood of success is higher for multicomponent interventions that prioritized credible influence and exercise referral as critical components besides offering access to interventions within hospital settings, with home-based sessions in addition.

Behavioural oncology research in Africa: Lessons from the last two decades and key considerations moving forward.

OBJECTIVE: To analyse the state of behavioural oncology research in Africa and outline key considerations for future research. METHODS: Five bibliographic databases were searched to identify original English-language articles published between January 2000 and August 2020. The Behavioural Epidemiology Framework was applied to studies with data/findings from Africa to delineate their current state. Research gaps/opportunities available for behavioural oncology research in Africa were further highlighted. RESULTS: Two hundred eighty-seven original research with findings from Africa has been published over the last two decades, with the highest contribution arising from Nigeria, Kenya, Ethiopia and South Africa. Cervical and breast cancers were the most widely investigated. Prominently studied behaviours relate to cancer screening, health literacy, lifestyle, and vaccination. Behavioural oncology literature in Africa is generally in Phases I and III and lacks in measurement studies (<2%) and studies that seek to evaluate behaviour change/health promotion interventions (<6%) or translate them into practice (13.2%). CONCLUSION: Embracing new and progressive approaches, including methodological/analytical paradigms and implementation science is imperative to advance the frontiers of behavioural oncology research in Africa. This calls for a responsive research approach that can mobilise multidisciplinary/multilevel coalitions, ensuring a research structure that effectively integrates behavioural research and cancer prevention/control in the region.

Factors Influencing Help-Seeking Behavior in Men with Symptoms of Prostate Cancer: A Qualitative Study Using an Ecological Perspective.

This qualitative study explored factors that could potentially influence help-seeking in men with symptoms of prostate cancer in Nigeria. A face-to-face interview was conducted with 27 men, between 54 and 84 years, diagnosed with prostate cancer ≤ 2 years prior to the interview. Data were analyzed using thematic framework approach. Several factors were identified and further captured as intrapersonal, interpersonal, and institutional/community level factors using an ecological perspective. These factors interact to impact negatively on the help-seeking behavior of men with symptoms of prostate cancer. These findings support the formulation of public health strategies to improve men's help-seeking behavior in Nigeria.

Living a burdensome and demanding life: A qualitative systematic review of the patients experiences of peripheral arterial disease.

BACKGROUND: Peripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. AIM: The aim of this study is to identify first-hand accounts of patients' experiences of living with PAD. METHODS: Six databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients' account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented. RESULTS: Fourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients' ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients' journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. CONCLUSIONS: Disease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.

Individual and work-related risk factors for musculoskeletal pain among computer workers in Nigeria.

We investigated the prevalence of musculoskeletal pain (MSP) and the association of 1-month prevalence with individual and work-related factors among commercial typists in Enugu. Participants responded to a questionnaire about occurrences of MSP and a 75.6% (242/320) response rate was achieved. Prevalence was summarized in frequencies and percentages while associations between MSPs and risk factors were explored using chi-square. MSP was most common in the low back (58.3%), and low back pain limited 51.7% from activities between 1 and 30 days. Advancing age was significantly associated with MSP in the low back (x2 = 19.885; p = .001), neck (x2 = 28.309; p < .001), shoulder (x2 = 13.122; p = .011), but not wrist/hand (p = .075). Working 1-5 years in this job was associated with increasing prevalence of MSP in all body regions studied. Lesser job control was associated with increased prevalence of wrist/hand pain. Prevalence of MSDs among computer operators in Enugu, Nigeria, is high and highlights the importance of workplace intervention.

Effect of Backpack Strap Patterns on Gait Parameters in Young Adults at Self-Selected Normal and Fast Walking Speeds.

BACKGROUND: The effects of backpack load on young adults' gait parameters have received little attention. We previously reported that with a backpack load within 15% body weight (BW), young adults maintain their gait parameters at the expense of increased exertion during a 6-minute walk at self-selected normal walking speed. However, the effect of backpack strap pattern on gait parameters during faster walking or longer stride length has not been evaluated. OBJECTIVE: To determine the effect of different backpack strap patterns on gait parameters during a 12-minute walk test in young adults at self-selected normal and fast walking speeds. DESIGN: A crossover, self-controlled experimental study with repeated measures. SETTING: Department of Medical Rehabilitation, University of Nigeria. PARTICIPANTS: A convenience sample of 24 healthy young adults (21.29 ± 1.20 years) who voluntarily signed an informed consent form, were able to wear a backpack on 1 and on both shoulders, were able to walk independently, and passed the physical activity readiness screening participated in this study. METHODS: Using a validated method of an observational gait analysis, each participant carried out a 12-minute walk test at self-determined normal and fast walking speeds, respectively. The effect of the following test conditions on the selected gait parameters was evaluated: normal and fast walking without load, and normal and fast walking with 10% and 20% BW backpack carried each on 1 and both shoulders. MAIN OUTCOME MEASUREMENT: Stride length, stride time, velocity, cadence, and base of support were assessed by the equation definitions method of the velocity field diagram. RESULTS: At self-selected fast walking speed with 10% BW backpack load, stride time (P = .004) and cadence (P = .006) were significantly decreased when participants wore a double-strap backpack. At self-selected normal walking speed with 20% BW backpack load, cadence was significantly decreased with double-strap backpack carriage (P = .008). Cadence (P < .001), velocity (P < .001), and stride time (P < .001)were also significantly decreased at both conditions of single and double-strap backpack carriage of 20% BW respectively at fast walking speed. CONCLUSION: Backpack strap patterns do not affect the gait parameters of young adults in a 12-minute bout of normal walking speed, provided that the load is less than 20% BW. However, a load up to 10% BW carried on a double strap causes a decrease in stride time and cadence when these individuals walk fast. LEVEL OF EVIDENCE: Not applicable.