Helping babies survive: Thermal and umbilical cord care practices for neonates in Ado-Ekiti, Southern Nigeria.

Newborn care practices immediately after delivery can decrease newborns' risk of diseases and death in early neonatal life. This study assessed thermal and umbilical cord care practices among mothers in randomly selected health care facilities in Ado-Ekiti, Ekiti State. Descriptive quantitative research design was used and 211 mothers were selected through convenience sampling techniques. Semi-structured questionnaire, adapted from a previous study was utilized to collect data which was analyzed using descriptive and inferential statistics. The majority of the respondents were Yoruba aged 20-29 years; 70% of the respondents were aware of the standard cord care practice; 90% agreed that heat should be applied to the newborn's umbilical cord. 70.5% of mothers used methylated spirit to clean the umbilical cord; 39.5% claimed that they used menthol ointment; while 20.5% used the standard prescribed chlorhexidine. On thermal care practices, 10% dried their babies, 39.5% bathed their babies immediately, while 50% of mothers wrapped their newborns in heavy clothing. Factors influencing common thermal and umbilical cord care include religion and cultural preferences. Efforts should be devoted towards providing tailored health education approaches on proper thermal and umbilical cord care practices to mothers and the community at large.

Nursing preceptorship in Ekiti State, Southwest Nigeria: Perceptions of nursing students and clinical preceptors.

Nursing preceptors play a vital role in providing skills-oriented opportunities for students in the clinical environment. This study assessed the perceptions of nursing students regarding the clinical learning experience provided by preceptors, and the perceptions of nursing preceptors regarding their roles in ensuring beneficial clinical accompaniment in the three nursing institutions in Ekiti State, Southwestern Nigeria. A concurrent mixed-methods design consisting of a survey and semi-structured interviews were used. A multistage (consecutive, purposive, and convenience) sampling technique was used to obtain quantitative data from 120 nursing students and qualitative data from 20 preceptors. Data were analyzed using descriptive and thematic content analysis. Findings showed that overall students' perceptions of the clinical learning experience were good (92%), 91.7% of the students wanted direct supervision and inadequate support was reported due to the low preceptor-to-student ratio. Preceptors acknowledged that clinical accompaniment is one of their roles, challenges mentioned include few number of preceptors, lack of policy requirements to guide their duties, and limited equipment. We conclude that there is a need to provide adequate preceptors in clinical settings, as they are vital to the training of nurses. A unified policy and standardized procedure manual will improve the quality of the delivery of preceptorships in training institutions.

Attitude and compliance of nurses to standard precautions to infection control in Ekiti State, Southwest Nigeria.

The attitude and compliance to standard precautions (SP) by nurses have been recognized as efficient and effective means to prevent and control infections among patients and healthcare workers. This study investigated nurses' attitude and compliance to standard precautions in tertiary hospitals in Ekiti State, Southwest Nigeria. A cross-sectional, descriptive research designs using purposive sampling techniques were used. Adapted and standardized instruments were used to elicit information from 137 nurses. Data were analyzed using descriptive and inferential statistics. Participants' age was between 21 and 62 years, with a mean age of 33.54± 9.41 years; 85.4% were females; while the majority had five to ten years working experience. Participants had poor attitude toward SP, but with good compliance (96.6%). All participants (100%) had good compliance with the use of personnel protective equipment, while most had good compliance with hand hygiene, respiratory hygiene, safety injection practice, clean environment, and sterilization of instruments. The ward/unit allocation of the nurses had a significant positive effect (R= 0.225, p= 0.008) on compliance with respiratory hygiene. Hence, sensitization programs should be intensified to ensure that health workers understand and comply with infection control through the use of SP.

Knowledge, attitude, and utilization of human papillomavirus vaccination among female undergraduates in Ekiti State, Nigeria.

Despite the introduction of the Human Papillomavirus (HPV) vaccine in Nigeria in 2009, vaccination rate is still low and the disease-related mortality remains high. This study evaluated the knowledge, attitude, and utilization of HPV vaccinations among female undergraduates in a university in Ekiti State, southwest Nigeria. This was an observational study that utilized a standardized questionnaire to obtain information from 200 female participants who were selected using multistage sampling technique. The data was analyzed and presented with descriptive statistics, while Chi- square was used to test any significance in observed differences and relationships between variables. About 53.3% of the respondents had fair knowledge of HPV. Results on utilization were extremely low as only 5.4% had received the vaccination in all three doses. The major barriers to HPV utilization were inadequate awareness about the vaccine (53.0%), concern about its cost and safety (41.1% and 40.1% respectively). We conclude that HPV vaccination campaign should be extensively encouraged especially among university students. The cost of the vaccine should be subsidised to encourage its uptake, thereby reducing cervical cancer incidence and deaths in the country.

Lived experiences of breast cancer survivors at the General Hospital Ilorin Kwara State Northcentral, Nigeria.

Breast cancer is a debilitating disease with severe physical, psychological, social, and financial consequences. A phenomenological approach was used in this study to investigate the lived experience of twenty-one (21) breast cancer survivors who were purposefully chosen until saturation was reached. Tesch's data analysis method was employed. The participants' ages ranged from 30 to 70 years old, with the majority (16 out of 21; 76.2%) diagnosed within the previous two years and many describing the treatment experience as unpleasant and painful, with numerous side effects including nausea, insomnia, sore throat, and hair loss. The majority of participants (16 of 21; 76.2%) reported financial hardship as a result of treatment costs. The disease's socioeconomic impact includes poor human relations, negative perceptions of breast cancer diagnosis, poor sociocultural roles, and negative effects on patients' livelihood. Breast cancer counseling should be expanded, government and other stakeholders should also consider subsidized breast cancer management.

Childbirth expectations and coping strategies of first-time mothers attending a comprehensive health centre in Ekiti State, Nigeria.

Childbirth is a complex life event for every woman. Women will have positive experiences if their expectations are met during childbirth, unmet expectations can result in negative experience. This study assessed the knowledge, expectations and coping strategies used by first time mothers attending a Comprehensive Health Center in Ekiti State. The study adopted a qualitative research design and twenty individual semi-structured interviews were conducted. Purposive sampling technique was used and the sample size was determined by saturation of data. Interviews were analyzed using qualitative thematic content analysis. Findings revealed limited knowledge about labour as majority of the participants had no knowledge of labour signs and process. Also, almost all the women were not familiar with the various methods for relief from discomfort during labour and first-time mothers expect midwives to care for them throughout the labour process. This study emphasized the need for healthcare professionals to provide suitable comprehensive education on the process and signs of labor as well as the various methods of pain relief. Supportive networks should also be provided for women during prenatal clinics. Also, health care professionals should consider the needs of mothers and try as much as possible to provide holistic support.

Lived experiences of prostate cancer patients in an urban metropolis in North Central, Nigeria.

Prostate cancer (PCa) is currently the second most prevalent cancer in the world and the most common type of cancer among Nigerian men. This study explored the lived experiences of patients with PCa at the General Hospital in Ilorin, Kwara State, Nigeria. A mixed-method design was adopted. Purposive and consecutive sampling techniques were employed to recruit 50 and 10 participants for the quantitative and qualitative aspects respectively. Qualitative data was analyzed using thematic content analysis while quantitative data was analyzed using descriptive and inferential statistics. All participants were above the age of 50 years, 72% earned about $100 monthly while 68% were diagnosed in less than five years. Majority of the participants utilized adaptive coping styles and also found the strategies moderately helpful while living with the effects of radical prostatectomy. Participants also found the high cost of treatment severely challenging. Government and other stakeholders may need to subsidize the cost of PCa management thereby encouraging early accessibility to care, improved adherence to treatment and also reduce the economic burden of the disease on patients and their families.

Lived experiences of patients with ostomies in a University Teaching Hospital in Kwara State, Nigeria.

The presence of an ostomy causes numerous alterations in the lives of individuals with ostomy. There is limited information on the experiences of persons with ostomy in Nigeria. This study aimed to explore the lived experiences and the coping strategies utilized by individuals with ostomy. A mixed method of qualitative and quantitative design was adopted. Using Johnson Behavioral Model, a semi structured interview guide was utilized to elicit responses on the experiences of participants while living with an ostomy. The Brief COPE inventory was employed to identify coping strategies utilized by ostomates. Consecutive sampling method was used to select participants for this study and data saturation was reached at 15 participants. Qualitative data was analyzed using thematic content analysis while descriptive statistics was used to analysed quantitative data. Socio-demographic profile of the participants showed that 33.3% were within the age of 45-55 years and majority (60%) had a colostomy. Also, 66.6% of the participants had a temporary ostomy. Findings from this study revealed that on the first sighting the stoma, ostomates experienced feelings of sadness, shame and disgust. A good number (10 of 15) of the participants had the support of family and friends which aided their adaptation process. Just less than half of the participants had difficulty carrying on with work as the presence of the stoma reduced their ability to work effectively. The study provided evidence that Johnson Behavioural Model is useful in assessing the effect of ostomy in the lives of patients and also gave insight into the coping strategies used by them. The information generated from this study will be useful in creating a more holistictic approach in pre- and post-operative management of individuals with ostomy thus improving their health quality of life.

Type 2 diabetes mellitus patients' lived experience at a tertiary hospital in Ekiti State, Nigeria.

Diabetes mellitus is a complex and chronic metabolic disorder that is associated with multiple complications and disabilities. This contributes to increased mortality and poor quality of life among affected individuals. The study explored the lived experience of patients with type 2 diabetes mellitus at a Teaching Hospital in Ekiti State, Nigeria. A mixed method of qualitative and quantitative design was adopted. For the quantitative aspect, a convenience sampling technique was employed while the instrument used was an adapted questionnaire. For the qualitative aspect, focus-group discussion involving twenty-four participants was conducted, and the sample size was determined by data saturation. Qualitative data was analyzed using thematic transcription. Findings revealed that 55.6% of the participants were females while 63.5% had tertiary education. Majority (18 of 24) of the respondents experienced body weakness, frequent urination and excessive thirst when diagnosed of diabetes mellitus and later experienced occasional body weakness, burning sensation, tingling and numbness of the feet, fatigue, loss of libido, and occasional visual disturbance. Two-third of the participants reported being indifferent when they were informed about their condition. However, majority of the participants perceived that the cause of diabetes mellitus was heredity. More than two-third of the participants did not experience reduction in their normal daily activities but rather experienced occasional emotional disturbances, anxiety and challenges with self-management of diabetes and this was associated with maintaining a normo-glycemic state due to the financial implications of drugs and dietary modifications.

Reproductive health outcomes: Insights from experts and verbal autopsies.

BACKGROUND: Reproductive health outcomes are a measure of maternal and neonatal health. South Africa's state of maternal health is of particular concern because of the two Millennium Development Goals (MDGs) targets for monitoring maternal health, namely MDG 5a, to reduce the maternal mortality rate by three-quarters, and MDG 5b, to achieve universal access to reproductive health by 2015. Maternal mortality ratio and universal access to reproductive health receive unequal responsiveness from government. Monitoring the maternal mortality ratio has received favourable attention compared to ensuring universal access to reproductive health, hence the limited published research findings on the latter. OBJECTIVES: The purpose of this article is to report on the insights from reproductive health experts and verbal autopsies on the determinants of poor reproductive health outcomes. METHOD: Individual interviews with a purposively selected sample of six reproductive health experts were conducted, augmented by verbal autopsies of 12 next of kin of women and newborn babies who died within the previous 2 years period of the study. Burnard's (1995) approach of content analysis was used to analyse the data. RESULTS: The findings revealed lack of empowerment, inaccessible reproductive health services and separation of patients living with human immune deficiency virus and those patients diagnosed with acquired immune deficiency syndrome. CONCLUSION: To meet the reproductive health needs, especially of the rural population, urgent attention is needed to reduce their vulnerability to the risks of poor reproductive outcomes.

The TEAM model for mental health promotion among school-going adolescents.

OBJECTIVE: This paper reports on the process followed in developing the "TEAM" (an acronym for the proposed intervention) model for the promotion of mental health among school-going adolescents. METHODS: A sequential explanatory mixed method combining both quantitative and qualitative approaches was used to gain in-depth understanding of the experiences of adolescents, school health nurses and teachers in dealing with emotional and social problems in high schools. Data collection was conducted in 4 phases from 2012 to 2015 and included a desk review of literature, qualitative interviews with 12 school teachers; qualitative interviews with 10 school health nurses and quantitative interviews with 347 adolescents. The quantitative tool that was used for the study was based on the Social and Emotional Learning Model. RESULTS: Key findings from the study revealed inappropriate handling of emotions by adolescents, leading them to form destructive groups (gangs); involvement in alcohol and substance abuse; disrespect; and adolescent pregnancy. CONCLUSION: A universal team-oriented collaborative model that will assist adolescents to shift negative energy and attitudes to positive and productive lifestyles is required. The TEAM model centres all the activities of a collaborative and focused team on the facilitation of a sense of belonging, ownership and complete engagement of pupils in schools that will contribute positively to social and emotional well-being.

Health status of families: A comparative study of one-parent and two-parent families in Ondo State, Nigeria.

BACKGROUND:  The family plays a central role in the provision and maintenance of health status of its members and all factors that contribute to achieving optimal health. Aim: To compare the health status of one-parent and two-parent families using the McMaster model of family functioning. Setting: Ondo State, Southwest Nigeria. Methods: A descriptive cross-sectional design, using multi-stage simple random sampling technique. Data were collected using an adopted self-administered questionnaire from 250 purposely selected families from each sample group. The data entering was analysed using Statistical Package for Social Sciences (SPSS) software version 17.0. Results: Findings showed that one-parent fathers scored higher (mean = 74.4 ± 10.30) than two-parent fathers (70.5 ± 13.05), while one-parent mothers scored higher (mean = 69.7 ± 15.10) than two-parent mothers (mean 67.7 ± 14.78). This means that one-parent fathers have a better self-reported health status than two-parent fathers, while one-parent mothers have a better self-reported health status than two-parent mothers. One-parent fathers have the best self-reported health status. No significant (p > 0.05) difference in the health status of children from both families. Conclusion: Fathers are healthier than mothers, while one-parent fathers are healthier than two-parent fathers. Comparing the two groups of families, parents from one-parent families reported better health status than parents from two-parent families, whereas within each family group, fathers reported better health status than mothers. This places responsibility on health care professionals to explore family contexts during clinic visits so as to render a more comprehensive health care service to families.

Perceptions of adolescents and teachers on school-based sexuality education in rural primary schools in Uganda.

BACKGROUND: Evidence-based sexuality education programmes are a cornerstone in reducing adolescent sexual risk behaviours and promoting sexual health. Several initiatives aimed at reducing sexual and reproductive problems among adolescents have been done. These initiatives include life skill education and abstinence program. Despite these initiatives teen pregnancy, sexually transmitted diseases and abortion are still common among school going adolescents. OBJECTIVES: The purpose of this study was to explore the experiences and perceptions of adolescents and teachers regarding school-based sexuality education in rural primary schools. METHODS: A purposive sample was drawn from primary school-going adolescents aged 12-16 years and teachers aged 28-52 in four rural schools. Eleven audio taped individual interviews and eight focus group discussions were used to collect data. A constant comparison method of data analysis was applied by following the Strauss and Corbin (1998) analysis process of open, axial and selective coding to analyse textual qualitative data until themes, categories and sub-categories were identified and developed. RESULTS: Data analysis revealed that adolescents benefitted from School Based Sexuality Education but the implementation of programmes was undermined by physical and contextual factors such as challenges at national, institutional, community, family and individual levels. CONCLUSION: It is vital to review the teaching and learning resources and to fully integrate sexuality education into the formal school curriculum. A combined effort of major stakeholders including teachers, community leaders, adolescents, healthcare professionals and parents is needed for sexuality education among adolescents to succeed.

Communication skills intervention: promoting effective communication between nurses and mechanically ventilated patients.

BACKGROUND: Patients in the Intensive Care Unit (ICU) often experience communication difficulties - usually associated with mechanical ventilation - resulting in psychological problems such as anxiety, fear, and depression. Good communication between nurses and patients is critical for success from personalised nursing care of each patient. The purpose of this study is to describe nurses' experience of a communication skills training intervention. METHODS: A convenience sample of twenty intensive care nurses participated in the study. Data was collected by means of interviews with nurses. Data from the interviews were analysed using qualitative thematic content analysis. RESULTS: Six themes emerged: (1) acceptance of knowledge and skills developed during workshops; (2) management support; (3) appreciation of augmentative and alternative communication (AAC) devices; (4) change in attitudes; and (5) the need to share knowledge with others and (6) inclusion of communication skills workshop training as an integral part of an orientation programme for all nurses. CONCLUSION: The findings of this study indicated that the application of augmentative and alternative communication devices and strategies can improve nurse-patient communication in intensive care units. Therefore, the implementation of communication skills training for intensive care nurses should constantly be encouraged and, indeed, introduced as a key element of ICU care training.

Stigma and discrimination within the Ethiopian health care settings: Views of inpatients living with human immunodeficiency virus and acquired immune deficiency syndrome.

BACKGROUND: Stigma and discrimination attached to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. Stigma and discrimination are more devastating when they occur in health care settings where it is least expected. AIM: To explore the factors attributable to stigma and discrimination of people living with HIV in two Ethiopian rural hospitals on what they thought of health care professionals (HCPs) attending to them. METHODS: A qualitative exploratory approach was used. Data collection was by means of audio-taped interview and Tesch's content analysis approach was used. The sample size for this study was determined by saturation of data and consisted of 16 participants who were people living with HIV admitted as inpatients to the two selected hospitals in Amhara region of Ethiopia. RESULTS: Participants' views were grouped into: fear of contact, delay of services, substandard services, denial of care, impoliteness of health care providers, breach of confidentiality and poor patient follow-up for persons infected with HIV. CONCLUSION: The health care settings have been recognised as one of the contexts where HIV and AIDS-related stigmatisation and discrimination can occur. Hospital policies and institutional support should be tailored to embrace people living with HIV as the provision of institutional support is imperative in creating a good working environment and improving the commitment of HCPs so as to enable them to provide holistic care for people living with HIV and AIDS (PLWHA) without discrimination.

HIV and AIDS-related stigma and discrimination in two referral hospitals in Ethiopia.

The aim of the study was to determine the magnitude of HIV and AIDS-related stigma and discrimination (SAD) and its associated factors in healthcare settings. Primary data were collected from June to September 2014 from two referral hospitals located in north-west Ethiopia. The study used pre-test/post-test design with a non-equivalent control group using a quantitative approach. Healthcare professionals were divided into strata and then, using the stratified random sampling technique, the study participants were selected from each stratum. The median age of study respondents in the treatment group was 32.2 years with standard deviation (SD) of 7.74. The regressions of stigma for the pre-tests of the first hospital and second hospital participants' knowledge about SAD-related issues and perceived risk of HIV infection were found to be significantly associated with stigma in the first hospital. In the first hospital, healthcare professionals who felt HIV risk of infection at different contact points with HIV-positive patients were more than 13 times more likely to present stigmatising attitudes towards the patients (OR = 13.46, p = 0.005). In the second hospital, only perceived risk of infection was significantly associated with stigma (p = 0.036). Interventions to lessen HIV and AIDS-related SAD in healthcare settings must focus on improving the knowledge, attitudes and practices of healthcare professionals as well as overcoming the institutional barriers existing in the healthcare settings through staff training and hospital strategy development.

HIV and AIDS-related stigma and discrimination in two referral hospitals in Ethiopia

The aim of the study was to determine the magnitude of HIV and AIDS-related stigma and discrimination (SAD) and its associated factors in healthcare settings. Primary data were collected from June to September 2014 from two referral hospitals located in north-west Ethiopia. The study used pre-test/post-test design with a non-equivalent control group using a quantitative approach. Healthcare professionals were divided into strata and then, using the stratified random sampling technique, the study participants were selected from each stratum. The median age of study respondents in the treatment group was 32.2 years with standard deviation (SD) of 7.74. The regressions of stigma for the pre-tests of the first hospital and second hospital participants' knowledge about SAD-related issues and perceived risk of HIV infection were found to be significantly associated with stigma in the first hospital. In the first hospital, healthcare professionals who felt HIV risk of infection at different contact points with HIV-positive patients were more than 13 times more likely to present stigmatising attitudes towards the patients (OR = 13.46, p = 0.005). In the second hospital, only perceived risk of infection was significantly associated with stigma (p = 0.036). Interventions to lessen HIV and AIDS-related SAD in healthcare settings must focus on improving the knowledge, attitudes and practices of healthcare professionals as well as overcoming the institutional barriers existing in the healthcare settings through staff training and hospital strategy development