Psychoeducation for psychological issues and birth preparedness in low- and middle-income countries: a systematic review.

BACKGROUND: Psychological issues usually accompany the pregnancy of first-time mothers, and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period. OBJECTIVE: This study aimed to identify, analyze, and synthesize the components and determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in low- and middle-income countries. STUDY DESIGN: A systematic search of 12 databases (APA PsycINFO, EmCare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health & Medical Collection, ProQuest, CINAHL, Cochrane, Hinari, and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. The quality of the included studies was appraised by the Joanna and Briggs Institute critical appraisal tool, and a narrative synthesis was performed to analyze data extracted from included articles. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42021237896). RESULTS: The initial search yielded 8658 articles. Of note, 16 articles, including 7 randomized controlled trials and 9 nonrandomized trials, met the inclusion criteria and were selected and reviewed for quality. In addition, 31 outcomes were measured in the studies, including psychological outcomes, birth preparedness outcomes, and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counseling. All the psychoeducational interventions had a significant effect (P<.05; Cohen's d or Hedges' g=0.2-1.9) on certain psychological outcomes, including childbirth attitude, fear of childbirth, depression, fear, and anxiety, and birth preparedness outcomes. CONCLUSION: Although first-time mothers experience a range of psychological issues during pregnancy, psychoeducational interventions were beneficial in addressing their psychological concerns. It would seem that these interventions are less expensive and could be easily implemented in low- and middle-income countries. However, rigorous research, such as randomized controlled trials, is hereby warranted to standardize the interventions and outcome assessment tools.

Oncology Training Needs Assessment Among Health Care Professionals in Nigeria.

PURPOSE: This study investigated the status of training and preparedness for oncology practice and research and degree of interprofessional collaboration among health care professionals in the six geopolitical regions of Nigeria. METHODS: A convergent parallel mixed methods design was used. Three hundred seventeen respondents completed a three-part, online questionnaire. Self-rated competencies in oncology research (26 items), oncology practice (16 items), and interprofessional collaboration (nine items) were assessed with a one- to five-point Likert scale. Six key informant and 24 in-depth interviews were conducted. Descriptive statistics, analysis of variance, and pairwise t-test were used to analyze the quantitative data, whereas thematic analysis was used for the qualitative data. RESULTS: Respondents were mostly female (65.6%) with a mean age of 40.5 ± 8.3 years. Respondents include 178 nurses (56.2%), 93 medical doctors (29.3%), and 46 pharmacists (14.5%). Self-assessed competencies in oncology practice differed significantly across the three groups of health care professionals (F = 4.789, P = .009). However, there was no significant difference across professions for competency in oncology research (F = 1.256, P = .286) and interprofessional collaboration (F = 1.120, P = .327). The majority of respondents (267, 82.4%) felt that educational opportunities in oncology-associated research in the country are inadequate and that this has implications for practice. Key training gaps reported include poor preparedness in data analysis and bioinformatics (138, 43.5%), writing clinical trials (119, 37.5%), and writing grant/research proposals (105, 33.1%). Challenges contributing to gaps in cancer research include few trained oncology specialists, low funding for research, and inadequate interprofessional collaboration. CONCLUSION: This study highlights gaps in oncology training and practice and an urgent need for interventions to enhance interprofessional training to improve quality of cancer care in Nigeria. These would accelerate progress toward strengthening the health care system and reducing global disparities in cancer outcomes.

Knowledge, preparedness, and attitude towards COVID-19 among health profession students in Sub-Saharan Africa: A cross-sectional survey.

Objective: We assessed the knowledge, preparedness, and attitude of health profession students towards COVID-19 outbreak in Sub-Saharan Africa. Methods: This cross-sectional study used convenience sampling to recruit participants from institutions under African Forum for Research and Education in Health (AFREhealth). The survey was developed in QuestionPro software covering the participants' socio-demographic characteristics, knowledge, attitude, and preparedness towards the COVID-19 outbreak. Data were analysed and the association between variables was tested. Results: The mean age of the 336 students was 25•75 (±7•88) years. Most (99•7%) knew the cause of COVID-19 which could be transmitted via droplets (97•3%). Several participants vowed to adhere to preventive measures (92•3%) and claimed their curriculum equipped them with skills addressing infectious disease outbreaks (63•6%). Nursing students were better prepared than other students (p=0•001). Students from West African regions were more prepared (p=0•001) and aware they could contract COVID-19 if they cared for infected persons (p=0•001). Conclusion: Students are knowledgeable about COVID-19, adequately prepared to handle epidemics, have a positive attitude towards infection prevention, and their training institutions and government have taken adequate measures to address the COVID-19 outbreak. Funding: AFREhealth.

Reproductive Plans And Utilization of Contraceptives Among Women Living With HIV.

BACKGROUND: Despite public health policies aimed at providing universal access to reproductive health care services, the reproductive health needs of women living with Human Immunodeficiency Virus (WLHIV) are not adequately met. This study assesses the reproductive plans and utilization of contraceptives among WLHIV. METHODS: This was a cross sectional descriptive study, which adopted a mixed method approach. A total of 400 respondents were recruited from two tertiary health institutions in Nigeria using systematic sampling technique. A validated structured self-administered questionnaire developed by the researcher was used to collect quantitative data for the study. The questionnaire consists of close ended questions related to study objectives. Quantitative data collected were coded and analyzed using Statistical Package for Social Sciences (SPSS) windows version 22 and statistical significance was set at p <0.05. The qualitative aspect of the study utilized focus group discussion for data collection. RESULTS: The mean and standard deviation (SD) age of enrolled respondents was 37.42±7.51 years, and about 59.0 percent were currently married. The prevalence of reproductive desire among WLHIV was comparatively high at 56.5 percent. Furthermore, about 57 percent of the WLHIV had good knowledge of available contraceptives. The current utilization of contraceptive was 47.3 percent. The results revealed significant association between knowledge level of contraceptive options and utilization of contraceptives (X2 = 7.21, df = 1, p =.007), and level of education and utilization of contraceptives (X2 = 21.02, df = 3, p =.001) among women living with HIV. Also, a significant association was found between the respondents' desires to have babies and their knowledge level of contraceptive options that prevent and reduce the risk of vertical transmission of HIV infection (X2= 13.717; P = 0.03). CONCLUSIONS AND GLOBAL HEALTH IMPLICATION: Quality reproductive health service bridges the gaps in the continuum of reproductive health and addresses the risk associated with pregnancy in WLHIV. Integration of reproductive health care in the management of HIV may improve the health of childbearing women living with HIV.

Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol.

BACKGROUND: The 2014 International Pressure Ulcer Prevention (PUP) Clinical Practice Guidelines (CPG) provides the most current evidence based strategies to prevent Pressure Ulcer (PU). The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. AIM: To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. METHODS: Guided by the Knowledge to Action (KTA) framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. RESULTS: A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. CONCLUSION: Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

Bilateral breast cancer among three Yoruba women in a Nigerian teaching hospital.

Breast cancer is the most common cancer among females in Nigeria. Bilateral breast cancer can occur synchronously or metachronously. We report three different cases of bilateral breast cancer in three female patients managed by the Ibadan Multidisciplinary Breast Tumour Board, domiciled at the University College Hospital (UCH), over a 3-year period. Two of these patients had synchronous bilateral breast cancer and developed cancer in the second breast during the course of management. These case reports may therefore stimulate further research on the clinicopathological features and the progression of bilateral breast cancer among females, especially in our environment. Our patients were premenopausal and the immunochemistry of the tumours showed a triple-negative immunophenotype. The other features of presentation, investigation, diagnosis and follow-up care are the highlights of this presentation.

A five-year prevalence study of burn injury in a Nigerian teaching hospital.

Burn injury has been observed as a worldwide problem. The knowledge of the epidemiology is important for planning of management and preventive programmes. This is a retrospective review of burn patients who presented with acute burn injuries between January 2006 and December 2010. Admission registers and patients' folders were the sources of information. The information obtained includes: age, gender, number of patients who died, sources of burn injury and outcome of management. A total of 407 patients with acute burn injuries were studied. Males numbered 274 (67.3%), females 133 (32.7%). A majority, 98 (24%) of burn injuries occurred in the year 2010 and mortality in the series increased progressively except for 2006 which is explainable by the strike due to industrial disputes between and among various health disciplines over the period. Mortality was highest in 2010 (30%). The prevalence was higher among males than females throughout the 5-year period. The incidence, prevalence and mortality of burn injury have remained high in this environment. We suggest a well-targeted prevention campaign program to reduce this high incidence and high mortality in burn injury in Nigeria.

Nurses' knowledge of pressure ulcer prevention in ogun state, Nigeria: results of a pilot survey .

 Pressure ulcer (PU) development remains a significant complication among at-risk patients. Optimal prevention strategies start with knowledge about current evidence-based prevention interventions. A pilot study was conducted to describe nurses' level of knowledge of PU preventive interventions and to test the reliability of the Pressure Ulcer Knowledge Test (PUKT) among Nigerian nurses. One hundred, eleven (111) nurses were purposively selected from specific wards of a state teaching hospital in South West Nigeria. While 106 nurses (95.5%) correctly identified patients at risk for PU development, 78 participants (70.3%) had low (<59% correct) prevention intervention knowledge scores. No significant differences in PU prevention intervention knowledge scores were observed between nurses with different educational backgrounds (P = 0.317) or years of working experience (P >0.005). The Cronbach's alpha coefficient for reliability was 0.861. The results of this study confirm that many PU prevention interventions in Nigeria are based on tradition and that a structured educational approach is needed to enable Nigerian nurses to provide evidence-based PU prevention interventions.

Nurses' use of water-filled gloves in preventing heel pressure ulcer in the University College Hospital, Ibadan, Nigeria.

This cross-sectional descriptive survey examined use (knowledge, perception and practices) of water-filled gloves (WFGs) by nurses in the prevention of heel pressure ulcer (PU) in the University College Hospital (UCH), Ibadan, Nigeria. Participants were 250 purposively selected nurses working in the Neurosciences and Surgical units. Quantitative data were generated through the administration of a semi-structured questionnaire, whereas the qualitative data were collected through in-depth interview. Hypotheses were tested using chi-square analysis at a significance level of 0.05, whereas the manual content analysis was used to analyse the qualitative data. Results showed that a significant number of nurses at UCH, Ibadan, were knowledgeable about WFGs and actually used them in their clinical practice. Years of experience in clinical practice was found to be significantly related to knowledge and use of WFGs in heel PU (X(2) = 41·677; DF = 5; P = 0·001). Nurses with adequate knowledge of risk factors in the development of PU used WFGs more than those who were not aware (X(2) = 44·907; DF = 3; P = 0·009). Nurses' perception about WFGs was also significantly related to its use (X(2) = 4·527; DF = 1; P = 0·033). Although knowledge level and perception of WFGs and its use by nurses was fairly adequate, continuous education for practicing nurses should be encouraged in resource-limited settings.