Challenges and support experienced by family caregivers seeking antiretroviral therapy services for children living with HIV/AIDS: a phenomenological study in Ghana.

BACKGROUND: Family caregivers of children living with HIV/AIDS in most cases are found to be overwhelmed and under-resourced, yet they are believed to be the primary source of support for children living with HIV/AIDS. Family caregivers experience different challenges that affect their children's antiretroviral therapy (ART) adherence. AIM: This study explored the lived experiences of family caregivers of children living with HIV/AIDS who sought ART services for these children at the St Joseph's Hospital of Jirapa, Ghana. METHOD: Using a qualitative phenomenology design and a semistructured in-depth interview guide and using purposive sampling, data were gathered from 13 family caregivers of children living with HIV/AIDS receiving ART treatment at St Joseph's Hospital, Jirapa following ethical approval. All interviews were audio-taped and transcribed verbatim. Reflexive thematic analysis was used to analyse the transcribed data. FINDINGS: Six themes were generated: five challenges and one support. Family caregivers of children living with HIV/AIDS experienced: (1) Financial challenges, (2) Human-related challenges, (3) Challenges at HIV testing and counselling (HTC) centres, (4) Challenges with transportation, (5) Challenges in disclosing children's HIV status to them and (6) Support received from HTC and their family members. CONCLUSION AND RECOMMENDATION: Family caregivers of children living with HIV/AIDS experience daunting challenges in their quest to care for their children. Governmental and non-governmental HIV/AIDS programme support should include small business skills training and acquisition including capital to help set up small-scale businesses for such caregivers to reduce their financial challenges. Access to ART at clinics closer to caregivers is also key to promoting adherence. Family and community support has been recognised as key to enhancing ART adherence. Education of caregivers on policy regarding disclosure of the HIV/AIDS status of children, the need to work to reduce the time spent by caregivers at HTC, and ensuring privacy by limiting access to HTCs to only caregivers and their children, are important to enhancing adherence.

A phenomenological study of the beliefs of family caregivers of children living with HIV/AIDS on adherence to antiretroviral therapy.

AIM: To explore the beliefs of family caregivers on adherence to Anti-Retroviral Therapy (ART) among children living with HIV/AIDS that received care at St. Joseph's Hospital, Jirapa, Ghana. DESIGN: A qualitative phenomenological design was employed for this study. METHOD: Data was gathered using a semi-structured in-depth interview guide from 13 family caregivers of children with HIV/AIDS on ART. Analysis was done using the reflexive thematic analysis approach. RESULTS: Three major themes were generated during the analysis: "Beliefs regarding the effectiveness of ART"; "Beliefs regarding taking ART"; and "Beliefs regarding other treatments for HIV/AIDS". Most caregivers believed that the ARTs were effective and improved their children's health, especially when adhered to strictly. Some, however, believed in praying to God for healing, and the use of local/herbal to augment ARTs. CONCLUSION: Family caregivers generally hold positive beliefs about ARTs and its effectiveness for their children. Some, however, believe in spirits, prayers, and herbal/local treatment in addition to ARTs.

Burden experienced by informal caregivers of children with sickle cell disease (SCD): a qualitative exploratory study at Tamale Teaching Hospital, Ghana.

OBJECTIVE: This study sought to explore the burden experienced by informal caregivers in caring for their children with sickle cell disease (SCD). DESIGN: A qualitative exploratory design was employed in the study using in-depth interviews. SETTING: The study was conducted at the sickle cell clinic of the Tamale Teaching Hospital, Ghana. PARTICIPANTS: Data were gathered from 15 purposively selected informal caregivers, whose children with SCD received care at the sickle cell clinic of the Tamale Teaching Hospital, using a semistructured in-depth interview guide in May-June 2021. Their responses were audio-taped, transcribed and analysed using the reflexive thematic analysis approach. RESULTS: Five major themes emerged from data analysis. These were: the burden of children's ill-health; financial burden; employment challenges; psychosocial burden and determinants of caregivers' burden. These burdens destabilised the personal lives, financial standing, social relationships, and employment of caregivers in general and that of other immediate family members, thus, impacting family processes and health. CONCLUSIONS: Health professionals must devise strategies for counselling, early diagnosis and effective management of children with SCD across Ghana. The Ministry of Health must subsidise medications and laboratory services for children with SCD to help minimise the financial burden on caregivers. Further, counselling and psychological support services must be established in hospitals to assist caregivers to cope effectively.

Nursing staff involvement of children in care activities: A cross-sectional study.

Background: Nurses' involvement of children in their care is essential to quality pediatric care. Various international guidelines stress the need for children's involvement in decisions and activities affecting their care and lives; widely known among them is the United Nations Convention on the Rights of the Child. This convention gives children the right to participate in decisions and activities that affect their growth and development. Objective: This study assessed the level of nursing staff involvement of children in care activities and the benefits they perceived from this involvement. Design: Descriptive cross-sectional study. Setting: Units of Evangelical Church of Ghana Hospital, Kpandai rendering services for children. Participants: A total of 116 nursing staff members were invited to participate; 97 (84%) responded. The term "nurses" in this study includes unlicensed nursing assistants, as well as licensed professional nursing staff. Methods: Descriptive statistics were used to analyze participants' demographic characteristics and the nurses' perceived benefits derived from children's involvement in care activities. A Chi-square test was used to analyze associations between nurses' demographic data and the level of nurses' involvement of children in care activities at a significance level of p< 0.05. Results: A majority (56.7%) of the nurses poorly involved children in their care activities. They either involved children to some extent or did not involve children at all. Nurses' age and gender predicted involvement. Older nurses aged 30 and above (56.4%) were more likely to involve children in care activities than those under 30 (26.1%) [p=0.003]. Female nurses (31.7%) were marginally less likely to involve children in their care activities than their male colleagues (51.8%) [p=0.049]. Most of the nurses agreed to several impactful benefits of involving children in care activities, thus benefiting children, caregivers, and health professionals. Conclusion: The overall level of nurses' involvement of children in care activities was poor. Policy documents to safeguard children's rights in healthcare involvement must be developed and implemented from the national down to the hospital level to safeguard children's rights to healthcare involvement.

Preceptors' perceptions of support, commitment to the preceptor role, and preferred incentives: A cross-sectional study.

AIM: This study aimed to explore the perceptions of preceptors regarding the support they receive in the preceptorship role, their commitment to the role, and the incentives that are important to them. BACKGROUND: Nurse preceptors in Ghana face numerous challenges in performing their roles as preceptors. Preceptors require support from hospitals and nursing schools to make the preceptorship experience more rewarding for both students and preceptors. However, the type of support that preceptors require and their commitment to the preceptor role have been scarcely investigated in Ghana. DESIGN: This was a quantitative descriptive cross-sectional study. METHODS: An online survey that incorporated three questionnaires and a demographic information section was used to collect data from 154 preceptors in four hospitals in the northern part of Ghana. Data was analyzed using the Statistical Package for Social Sciences (SPSS) for Windows, version 26. Descriptive statistics, correlations, and multiple linear regression were used to analyze the data. RESULTS: Preceptors reported high levels of support in the preceptor role and perceived themselves to be highly committed to the role. Preceptors identified preceptor training, continuing education opportunities, and textbooks on effective preceptorship as the three most important incentives to them. No associations were found between perceived commitment and demographic characteristics of participants. CONCLUSIONS: Although many preceptors in Ghana feel satisfied with the support they receive to perform their role as preceptors, a significant number of preceptors do not feel adequately supported. Preceptor support should be geared more towards the professional development of preceptors.

Nursing and Midwifery Students' Satisfaction with Their Clinical Rotation Experience: The Role of the Clinical Learning Environment.

BACKGROUND: The clinical learning environment and clinical rotation experience of students are integral to nursing curriculum and are a crucial component of nursing education which helps transform theoretical knowledge to clinical practical skills. OBJECTIVE: This study was aimed at assessing the role of the clinical learning environment on undergraduate nursing and midwifery students' satisfaction with their clinical rotation experience. METHOD: The study employed a quantitative cross-sectional survey design. Data was collected from a sample of 240 undergraduate nursing and midwifery students of the University for Development Studies, Tamale, Ghana, using a structured questionnaire. Ethical approval was obtained from the University of Cape Coast Ethics Review Board. Descriptive analysis was displayed as frequencies and percentages. Inferentially, Fisher's exact test, linear regression, and Spearman's correlation tests were used to test for and quantify associations between independent and dependent variables at p ≤ 0.05. RESULTS: The level of students' satisfaction with both clinical rotation experience and the clinical learning environment was high (65.6% and 63.5%, respectively). A statistically significant association of the students' satisfaction with their clinical rotation experience was found. There was a statistically significant relationship between the clinical learning environment (χ 2 (9, N = 224) = 80.665, p < 0.001), pedagogical atmosphere in the clinical area (r s = 0.379, p < 0.001), the leadership style of the ward manager (r s = 0.340, p < 0.001), the premises of nursing in the ward environment (r s = 0.501, p < 0.001), and the students' satisfaction with their clinical rotation experience. CONCLUSION: These findings provide nurse educators and clinicians with meaningful understanding about areas to prioritise when planning clinical learning opportunities in such a way that skills learning and practice of nursing skills are successful and satisfactory for undergraduate student nurses and midwives.

Knowledge and Experience of Neonatal Resuscitation among Midwives in Tamale.

Background. Efforts to reduce under-five mortality across the globe are being hindered by a disproportionately high rate of neonatal deaths. About a quarter of these neonatal deaths are caused by birth asphyxia. Available evidence shows that effective neonatal resuscitation delivered by providers skilled in and knowledgeable about neonatal resuscitation can significantly reduce neonatal mortality rates. Objectives. This cross-sectional study was conducted to determine knowledge and experience in neonatal resuscitation among midwives in Tamale, and the factors associated with their knowledge on neonatal resuscitation. Methods. This was a cross-sectional study involving all midwives practicing in three large hospitals in Tamale. We developed a questionnaire to collect data on demographic characteristics of participants, and their knowledge and experience in neonatal resuscitation. We used the Statistical Package for Social Sciences (SPSS), version 21, to analyse the data. Demographic characteristics of participants were summarized using descriptive statistics. Pearson's correlation was used to determine associations between knowledge and some selected demographic features, while the one-way ANOVA was conducted to determine differences in level of knowledge based on the demographic features. Results. 98.1% of the participants in this study had insufficient knowledge on neonatal resuscitation. Midwives at the Tamale Central Hospital demonstrated a statistically significantly higher level of knowledge (24.67 ± 2.79, p = .014), compared to those at the Tamale Teaching Hospital (22.92 ± 4.56, p = .028) and Tamale West Hospital (21.50 ± 6.24, p = .021). Those who had a first-degree qualification in midwifery and those with a Post-NAC/NAP midwifery certificate had a statistically significantly higher knowledge than those with a diploma in midwifery. Training in neonatal resuscitation was associated with more knowledge in neonatal resuscitation (r(158) = .195, p = .013). In terms of experience, 55% of the participants in this study were not experienced in performing neonatal resuscitation. There were no differences in their level of experience based on their academic qualification, work place, and years of practice as a midwife. Conclusion. Considering the generally low level of knowledge and experience of midwives in neonatal resuscitation as discovered in this study, there is an urgent need for government to provide more opportunities for all practicing midwives to be trained in this important lifesaving skill.