Sexual Role Functioning, Sexual Satisfaction, and Intimacy After Surviving Burn Injuries: A Scoping Review of Associated Factors, Screening Tools, and Burn Care Staff Preparedness.

Although concerns regarding intimacy abound among burn survivors, these are often not captured during rehabilitation. Considering that sexuality remains a part of humans suggests a critical need to pay attention to this aspect. To guide further work, this review sought to examine existing studies to ascertain what is known about factors associated with sexual role functioning, sexual satisfaction, and intimacy, the screening tools employed, and the preparedness of burn care staff in initiating discussions about these. We employed a scoping review approach with extensive searches in four peer-reviewed databases for studies reporting on the phenomenon, published in English from 2010 to date. Seventeen studies comprising of thirteen studies reporting on the burn survivors and four reporting on burn care staff were retained. Though we identified both sociodemographic and clinical factors associated with post-burn sexual role functioning, sexual satisfaction, and intimacy, the existing evidence appear limited which made it rather difficult to draw definitive conclusions. The sexuality subscale of the Burn Specific Health Scale- Brief emerged as the commonly used screening/ assessment tool. The evidence suggest that burn care staff are generally unprepared to initiate discussions regarding sexual role functioning, sexual satisfaction, and intimacy and often, there is no personnel assigned to this task. There is a great need for studies to strengthen the evidence base regarding the factors associated with post-burn sexual role functioning, sexual satisfaction, and intimacy. Additionally, it is imperative to build capacity of burn care practitioners with the requisite know-how needed to navigate through sexual issues.

Exploring the challenges of public health nurses in the management of infertility in Northern Ghana: a qualitative descriptive study.

OBJECTIVE: To explore the challenges public health nurses (PNHs) face in managing infertility in rural settings of the Talensi and Nabdam districts in the Upper East Region of Ghana. DESIGN: The study adopted a qualitative descriptive design approach where PHNs who worked in rural settings were interviewed using a semistructured interview guide. Thematic analysis was employed to analyse the data. SETTING: Primary healthcare setting in the Upper East Region of Ghana. PARTICIPANTS: The study participants were 15 PHNs working in primary health centres with a mean age of 36.9 years (SD=6.40). RESULTS: This study revealed that couples with infertility issues face challenges in seeking care for their condition. The challenges expressed by the participants that affect individual and couples' access to infertility care were (1) lack of material and human resources, (2) lack of specialists and guides for infertility treatment and (3) inadequate and inconsiderate communication. CONCLUSION: This study provides evidence of the challenges experienced by PHNs in managing infertility among couples. Adequate measures are therefore required to ameliorate these challenges to improve care provision for couples with infertility.

The extended case method in nursing research: Unpacking the 'what', 'why' and 'how'.

BACKGROUND: The extended case method approach has been in existence for decades, albeit remains poorly utilized in nursing, though there are several phenomena of interest to the discipline that may potentially benefit from this unique approach. This provides an avenue to examine the extended case method approach and how to employ it to examine phenomena of interest to the discipline of nursing. OBJECTIVES: To examine what the extended case method is, why it should be employed to examine phenomena of interest to nursing, highlight some studies that have employed the approach in nursing, and offer methodological guidance to support its conduct and uptake in nursing research. DESIGN: Discussion paper. FINDINGS: The extended case method emphasizes the use of a theory and focuses on discovering how underlying structures at the micro level are affected by broader social forces. This makes it a useful approach to examine how macro level theories affect vulnerable, marginalized persons, which makes it particularly useful to the discipline of nursing. The approach is flexible, and there are no strict steps to be followed, albeit three important stages are highlighted. DISCUSSION: The extended case method offers a unique approach to examining how policies, rules and structures come into play in phenomena of interest to the discipline of nursing. This notwithstanding, the use of this approach is resource intensive. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: The extended case method is a unique qualitative design applicable to examining understudied, emerging and established phenomena relevant to nursing. The focus of the extended case method is to examine 'what is' and 'what ought to be'. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention.

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

Exploring the cultural perspectives and implications of infertility among couples in the Talensi and Nabdam Districts of the upper east region of Ghana.

BACKGROUND: Infertility remains a major clinical and social problem, affecting approximately one in every 10 couples. It is a reproductive health condition that is silently experienced with deep repercussions in the essence of self. In Ghana childbearing is considered a social prestige, where the couples are unduly pressurized to bear children for purposes of genealogical continuity. PURPOSE: This study explored the cultural perspectives and implications among males and females experiencing infertility in the Talensi and Nabdam districts of the Upper East Region of Ghana. METHODS: This study used an ethnographic design to explore the perspectives of couples on socio-cultural beliefs about infertility on 15 participants made up of 8 male and 7 female couple units. Participants were selected using a purposive sampling technique while semi-structured interviews were used to explore the cultural implications on male and female couple units. The data were analysed using Tesch's method of analysing qualitative data. RESULTS: Two broad themes and five subthemes emerged from the data analysis regarding the cultural implications of infertility. The major themes and subthemes include: (1) Varying cultural perceptions of infertility (Cultural beliefs and perceptions regarding causes of infertility, cultural consequences of infertility and traditional remedies for infertility), and (2) family dynamics stemming from infertility (abuse from family members, and parenthood as a standard for family inheritance). CONCLUSIONS: This study adduces evidence of the cultural implications of infertility in rural Ghana. Considering the cultural inclination of most Ghanaian communities, especially the current study setting, it is imperative that policymakers and public health practitioners should consider fertility interventions that are culturally sensitive. Also, culturally sensitive intervention programs that are targeted at increasing the awareness of the rural population on fertility and its treatment should be considered.

The role of community engagement toward ensuring healthy lives: a case study of COVID-19 management in two Ghanaian municipalities.

Introduction: Community engagement is one of the important requirements for strengthening health delivery in communities in a bid to achieve sustainable development goal 3, target 3.3 (SDG 3.3). The World Health Organization has strongly encouraged the use the five levels of community engagement, which are informing, consulting, planning, collaborating, and empowering communities in order to build resilience and to enable them contribute to the fight against diseases and for the uptake of health interventions. This study sought to explore and describe from the view of government institutions in Ghana how they engaged communities in COVID- 19 management and vaccine acceptance and how the communities within two municipalities also perceived the engagement process as well as the lessons that can be learned in engaging communities to deal with other health challenges and interventions toward the attainment of SDG 3 target 3.3. Materials and methods: This case study qualitative research project employed in-depth interviews among 36 respondents composed of government officials (the Ghana Health Service (GHS), the Information Services Department (ISD), the National Commission on Civic Education (NCCE) and two Municipal Assemblies), and community leaders and 10 focus group discussions among 87 men and women most of whom were natives and some migrants in two administrative municipalities in Ghana. Data were collected from June to September 2021. Audio interviews were transcribed and uploaded to Nvivo 12 to support triangulation, coding, and thematic analysis. Ethical approval was obtained from the University of Health and Allied Sciences' Research Ethics Committee and all COVID-19 restrictions were observed. Results: The findings revealed that all the four government institutions educated and informed the communities within their municipalities on COVID-19 management and vaccine acceptance. However, the Ghana Health Service was the most effective in the engagement spectrum of the other four; consulting, involving, collaborating, and empowering communities in the process of COVID-19 management and vaccine acceptance. The GHS achieved that through its CHPS program, which ensured a decentralized health service provision system with multiple programs and leveraging on its multiple programs to reach out to the communities. Government institutions such as the NCCE and the ISD faced challenges such as limited funding and support from the government to be able to carry out their tasks. Additionally, they were not involved with the communities prior to the pandemic and for that matter, they did not have access to community systems such as committees, and existing groups to facilitate the engagement process. Discussion: Using communities to support Ghana's attainment of the SDG 3 target 3.3 is possible; however, the government needs to provide funds and resources to the institutions responsible to enable them to carry out community engagement effectively. Also, promoting decentralization among institutions can strengthen community engagement processes. It is important that state institutions continue to strategize to empower communities in order to promote their participation in healthcare interventions and in the fight against infectious diseases in Ghana.

A Descriptive Exploratory Study of the Causes and Effects of Hypertension Among Ghanaian Soldiers and Their Families.

Introduction: The quality of life of any soldier can be affected by a simple diagnosis of Hypertension. Hypertension has not been directly linked to a single cause; however, knowing the associated risks and early diagnosis can help with its management. This study aimed to explore and describe the causes of hypertension among soldiers and its effects on their families. Objectives: To explore and describe the causes of hypertension and its effects on soldiers and their families. Methods: A qualitative technique and an exploratory descriptive design were used in this study. At saturation, a total of 10 soldiers were face-to-face interviewed and gathered data simultaneously transcribed and subjected to a content analytic method of analysis. Participants approved being audio recorded on tape with an audio recording device. Results: Effects of hypertension on personal lives of soldiers, effects of hypertension on family life, and effects of hypertension on social life were identified as the causes and risk factors of hypertension among the soldiers. These themes are further expanded by their subthemes in the areas of decreased physical activity including sex life, decrease interaction with family, and isolation from friends. Conclusion: This study revealed that hypertension does have effects on one's personal life, family life, and social life. Hence, it is recommended that frequent health education on hypertension and its effects should be organized in the various Garrisons by the public health department for all soldiers and their families. Screening programs should be organized for early hypertension detection. Soldiers should be educated on appropriate eating habits, weight and financial management, and reduction in tobacco and alcohol.

A qualitative exploratory study on the effects of formalin on mortuary attendants.

Objectives: To explore the effects of formalin on mortuary attendants in nine selected hospitals in Ghana. Methods: The study applies a qualitative exploratory descriptive design in the overall collection and analysis of data. Purposive sampling was used to reach the saturation of 19 participants. The data were collected through semi-structured interviews and manually analysed using content analysis. Results: Five themes developed from the analysed data, namely, effects of formalin on the eyes, effects of formalin on the respiratory system, effects of formalin on the skin, effects on appetite, and formalin as a cancer-causing agent. Conclusion: This study has unveiled the negative effects of formalin on morgue attendants, which is likely to cause long-time health problems. It is therefore recommended that all mortuaries in Ghana should be assisted with protective equipment, in-service training, and practice of universal safety to help reduce risks associated with chemical hazards, especially formalin. There should be regular surveillance in the mortuaries and workers be screened regularly.

Leveraging breast cancer screening to promote timely detection, diagnosis and treatment among women in sub-Saharan Africa: a scoping review protocol.

INTRODUCTION: Female breast cancer is now the most often diagnosed cancer in the world. Breast cancer screening aims to reduce mortalities related to cancer, and morbidity associated with advanced stages of the disease, through timely detection in asymptomatic women. This study aims to conduct a comprehensive assessment and evaluation of the evidence on the factors that influence the provision and uptake of breast cancer screening among women in sub-Saharan Africa (SSA). METHODS AND ANALYSIS: PubMed, Web of Science, EMBASE and the Cumulative Index to Nursing and Allied Health Literature including Google Scholar will be searched to identify published studies on barriers and facilitators to breast cancer screening from January 2010 to 2021. Two reviewers will independently assess the quality of all the included studies using the Mixed Methods Appraisal Tool version 2018. We envisage that this review will adduce evidence on common barriers and facilitators to breast cancer screening in SSA. Identifying these barriers and facilitators will help guide the initialisation of effective interventions that will improve breast cancer screening uptake among women in SSA. This review will also guide future research in developing, implementing and evaluating appropriate interventions tailored toward increasing breast cancer screening uptake. ETHICS AND DISSEMINATION: Ethics approval for this protocol is not required since it does not involve collecting data from human participants. The outcomes of this study will be published in a peer-reviewed journal.

Challenges experienced by midwives working in rural communities in the Upper East Region of Ghana: a qualitative study.

BACKGROUND: In 2017, a total of 295,000 women lost their lives due to pregnancy and childbirth across the globe, with sub-Saharan Africa and South Asia accounting for approximately 86 % of all maternal deaths. The maternal mortality ratio in Ghana is exceptionally high, with approximately 308 deaths/100,000 live births in 2017. Most of these maternal deaths occur in rural areas than in urban areas. Thus, we aimed to explore and gain insights into midwives' experiences of working and providing women-centred care in rural northern Ghana. METHODS: A qualitative descriptive exploratory design was used to explore the challenges midwives face in delivering women-centred midwifery care in low-resource, rural areas. A total of 30 midwives practicing in the Upper East Region of Ghana were purposefully selected. Data were collected using individual semistructured interviews and analysed through qualitative content analysis. RESULTS: Five main themes emerged from the data analysis. These themes included were: inadequate infrastructure (lack of bed and physical space), shortage of midwifery staff, logistical challenges, lack of motivation, and limited in-service training opportunities. CONCLUSIONS: Midwives experience myriad challenges in providing sufficient women-centred care in rural Ghana. To overcome these challenges, measures such as providing adequate beds and physical space, making more equipment available, and increasing midwifery staff strength to reduce individual workload, coupled with motivation from facility managers, are needed.

Challenges of being a hospital nurse manager in the Volta region of Ghana: a qualitative study.

AIM: To explore the challenges facing hospital nurse managers (HNMs) in selected hospitals in the Volta region of Ghana. METHOD: The study, which had an exploratory qualitative design, involved the recruitment of 12 HNMs from six public hospitals in the Volta region of Ghana. Purposive sampling was used and data were collected through semi-structured interviews. The conventional content analysis approach was adopted for data analysis. FINDINGS: The study revealed several managerial challenges of being HNMs in performing their roles. These include: a lack of managerial preparedness, clear job descriptions and support; interference by other managers; and inadequate nursing staff and material resources. All these compromised the quality of nursing care. Participants found their role tedious and stressful, but also regard it as an opportunity to learn new ideas. CONCLUSION: HNMs face several challenges that negatively affect their performance. There is a need for succession planning, career development and mentoring programmes to strengthen HNMs' leadership and management skills to help them provide high-quality nursing care.

Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana.

The third Sustainable Development Goal (SDG) for child health, which targets ending preventable deaths of neonates and children under five years of age by 2030, may not be met without substantial reduction of neonatal sepsis-specific mortality in developing countries. This study aimed at assessing the prevalence and risk factors for neonatal sepsis among neonates who were delivered via caesarean section. A retrospective case-control study was conducted among neonates who were delivered via caesarean section at the Trauma and Specialist Hospital, Winneba, Ghana. Data collection lasted for 4 weeks. The extracted data were double-entered using Epidata software version 3.1 to address discrepancies of data entry. Descriptive statistics such as frequencies and percentages of neonatal characteristics were generated from the data. Both univariate and multivariate logistic regression were used to determine associations between neonatal sepsis and neonatal characteristics with odds ratios, 95% confidence intervals, and p values calculated using variables that showed significant association (p<0.05) in the chi-square analysis for the multivariate logistic regression. A total of 383 neonates were recruited; 67 (17.5%) had sepsis (cases). The neonatal risk factors associated with sepsis were birth weight (χ2=6.64, p=0.036), neonatal age (χ2=38.31, p<0.001), meconium passed (χ2=12.95, p<0.001), reason for CS (χ2=24.27, p<0.001), and the duration of stay on admission (χ2=36.69, p<0.001). Neonatal sepsis poses a serious threat to the survival of the newborn as the current study uncovered 6.0% deaths among sepsis cases. The findings of this study highlight the need for routine assessment of neonates in order to identify risk factors for neonatal sepsis and to curb the disease burden on neonatal mortality.

A Qualitative Study on Women's Experiences of Intrapartum Nursing Care at Tamale Teaching Hospital (TTH), Ghana.

Introduction: Labor and delivery process is an exciting, anxiety-provoking, but rewarding time for a woman and her family after successful delivery of a newborn. The intrapartum period is the time where mothers expect more care. Taking care of a mother through delivery with no side effects is the task of a professional midwife who is trained with the skill to take the responsibility of caring for mothers and babies. Therefore, the aim of this study was to explore mother's experiences regarding quality of intrapartum nursing/midwifery care. Methods: Focused ethnographic study was employed. Data were collected from May to June 2016 TTH, Ghana using semi structured interview guide. Purposive sampling was employed to recruit 20 participants. Eight individual interviews were conducted in the post natal ward after 48 hours of delivery, followed by three focus group discussions two weeks after delivery when mothers visited post natal clinic. Interviews lasted for about 30-45 minutes during each session. Data were analyzed using thematic analysis. Results: The average age of women were 29 years with ranging from 19-43 years. Participants' experiences of nursing/midwifery care during birth were influenced by reception and respect, provision of information, technical skill, providers' behavior, pain management and availability of nurses/midwives. Conclusion: The study findings have revealed that women's experience of care is affected by a wide range of determinants. Therefore, maternal health programs and policies in Ghana must take into account women's perspective on the care they need and their feedback on services they receive. Nursing education should re-enforce communication/relational skills.