Effectiveness of educational interventions on hypertensive patients' self-management behaviours: an umbrella review protocol.

BACKGROUND: Although different educational interventions have been widely used to manage and treat hypertension, alone or in combination with other interventions, there is a significant variation in their claimed effectiveness. REVIEW QUESTION/OBJECTIVE: The objective of this umbrella review is to determine the effectiveness of educational interventions, alone or in combination with other interventions, for improving blood pressure control and self-management practices among hypertensive patients. The review question is: Do educational interventions, alone or in combination with other interventions, improve self-management practices among patients with hypertension? METHODS: We will conduct a review of systematic reviews involving studies that implemented educational interventions, alone or in combination with other interventions, designed to change self-care practices among hypertensive patients who are 18 years and above, regardless of their sex and ethnicity. Following the guidelines set forth in the Preferred Reporting Items for Systematic Review and Meta-Analysis statement, a comprehensive literature search will be conducted from September to December 2023 on six electronic databases: MEDLINE, Embase, PsycINFO, CINAHL, Web of Science Core Collection and Google Scholar. Search terms will be developed using database-specific indexed terms and text words derived from the review aim. We will present the effects of the educational interventions, alone or in combination with other interventions, on hypertension self-management practices. We will report the outcome data with 95% CIs for each study. Relative risk, mean differences or ORs will be used, depending on the measuring indices in each study. ETHICS AND DISSEMINATION: Ethical approval is not required as this study will use aggregated data from previously published systematic reviews. However, we have registered the protocol in PROSPERO. We confirm that all methods will be performed following the guidelines of the Declaration of Helsinki. The findings from this study will be disseminated through presentations at academic conferences and publication in peer-reviewed international journals. PROSPERO REGISTRATION NUMBER: CRD42022375581.

Health-related quality of life associated with different cervical cancer therapies received by patients in two Nigerian tertiary hospitals.

Background: There are important consequences from cervical cancer (CC) disease and its treatment among survivors, especially the impact on quality of life (QoL). Objective: To evaluate the health-related QoL associated with different CC therapies received by patients in two Nigerian tertiary hospitals. Methods: This study employed a prospective longitudinal design. It was conducted at Usmanu Danfodiyo University Teaching Hospital, Sokoto and Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria. Data of all the 157 eligible CC patients were collected at baseline and after therapy. Data analysis was done with appropriate descriptive and inferential statistics using SPSS V. 20 for windows. P<0.05 was considered statistically significant. Results: Chemotherapy (CT) was the major therapy option received by 78(49.7%) of the patients. Patients who received chemoradiation therapy (CRT) and adjuvant chemotherapy (CTS) had the highest increase in mean overall health-related QoL of 0.138 (t=8.456, p<0.001) and 0.138 (t=6.489, p<0.001) higher than their respective baseline scores. Patients who received CT had the least increase in mean overall health-related QoL of 0.095 (t=4.574, p<0.001) from baseline. Conclusion: Chemoradiation therapy and adjuvant chemotherapy were associated with highest increase in mean overall health-related QoL. Chemotherapy was associated with the least increase in mean overall health-related QoL.

Development and reliability testing of a cervical cancer patients knowledge and practice of self-care management of treatment-related adverse events questionnaire.

INTRODUCTION: Cervical cancer (CC) treatment-related adverse events (AEs) were found to be among the major reasons for treatments delays and medication non-adherence. Knowledge and practice of self-care management of these AEs are therefore needed to complement the pharmacotherapeutic interventions. Instruments for assessing CC patients' knowledge and practice of self-care management of treatment-related Adverse Events (AEs) are lacking. Hence, the rational for this study. METHODS: A prospective, cross-sectional study was conducted on CC patients receiving chemotherapy, radiotherapy or both, with or without surgery in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, a tertiary hospital in North-Western Nigeria. A panel of 14 experts judged the content validity of the items initially selected. Purposive sampling technique was used, 31 CC patients were recruited and interviewed for the questionnaire pre-testing. Descriptive statistics and psychometric analysis were conducted using SPSS Version 20.0 for Windows. A Cronbach's alpha coefficient ≥0.70 was considered acceptable. RESULTS: A 12-domain questionnaire instrument was developed. Eight (57.1%) of the expert panelists rated the questions' items as "Very good for the study" and none of them rated any of the content "not relevant for the study". The reliability studies showed that the overall knowledge and practice questions response rates were 71.0% and 77.4% and Cronbach's alpha (α) values were 0.956 and 0.913, respectively. CONCLUSION: A reliable, 12-domain cervical cancer patients' knowledge and practice of self-care management of treatment-related adverse events questionnaire was developed. Further research on the psychometric qualities of the instrument is needed.

Pharmacy graduates' perceptions of competency, integration, and social accountability in the undergraduate curriculum of pharmacy schools in Nigeria.

INTRODUCTION: An integrated, competency-based curriculum that fosters social accountability including cultural sensitivity among graduates is an educational strategy towards producing practice-ready professionals. This study aimed to evaluate pharmacy graduates' perceptions of competency, integration, and social accountability in the undergraduate curriculum of Nigerian schools of pharmacy. METHODS: A cross-sectional online survey consisting of a 42-item questionnaire was administered to 467 purposively selected pharmacy graduates who completed their undergraduate training between January 2012 and February 2020 from 20 accredited Nigerian pharmacy schools. Mann-Whitney U test was used to determine the differences in the participants' responses on a Likert scale. RESULTS: Of 467 participants, 54.4% felt that the Nigerian undergraduate pharmacy curriculum was not adequate in content, while 54.2% felt the courses in the curriculum were not well integrated to facilitate easy learning by students. About half (50.6%) strongly agreed or agreed that "the basic pharmacy courses are well synchronized with the clinical components" but 28.9% strongly disagreed or disagreed. The majority (88%), with no significant difference between gender (z = -1.615, P = .11), strongly agreed or agreed that they apply knowledge of clients' culture and disparity to deliver pharmaceutical services. CONCLUSIONS: Marginally above half of the graduates perceived the Nigerian undergraduate pharmacy curriculum to be deficient in course content. There is evidence of limited integration and social accountability in the curriculum. Cultural sensitivity appears to be a component of the curriculum but this needs to be properly structured. The pedagogy strategy for learning cultural sensitivity should be further interrogated.

Perceived stress and its predictors, stressors and coping strategies among undergraduate pharmacy students in northern Nigeria.

INTRODUCTION: Pharmacy education may be associated with stress due to the nature of its curriculum and expectations of high-quality services from students on graduation. This study evaluated perceived stress and its predictors, stressors, and coping strategies among undergraduate pharmacy students in northern Nigeria. METHODS: This was a prospective longitudinal study conducted at three randomly selected pharmacy schools in northern Nigeria. The validated 10-item Perceived Stress Scale was used to assess participant stress at the beginning (Time1) and middle (Time2) of the semester. Data were analyzed with descriptive statistics, a paired sample t-test, point-biserial correlations, and multivariate linear regression at P < .05. RESULTS: The stress scores at Time1 and Time2 of the 866 participants were 18.3 ±â€¯6.0 and 19.3 ±â€¯5.4, respectively. Most participants at both Time1 and Time2 had moderate stress (76.6% and 79.6%, respectively). The multivariate regression analyses revealed gender, marital status, year of study, and access to education funds as significant predictors of stress. Major stressors identified were academic-related (76.3%) and environment-related (24.6%). Time management (69.6%) and relaxation (46.1%) were the major coping strategies. CONCLUSIONS: Moderate stress was observed among the majority of participants. Identified predictors of stress, stressors, and coping mechanisms were similar to those previously reported in other countries. Although most pharmacy students adopt positive strategies to mitigate stress, pharmacy educators should further adopt holistic initiatives to help students reduce their stress.