Prevalence and risk factors of hypertension among adolescents living in Ghana.

This study assessed the prevalence of and risk factors for hypertension among adolescents in two selected districts in Ghana. The data were analyzed using SPSS version 24. Multivariate logistic regression analyses were conducted to determine the risk factors of hypertension among adolescents. The overall prevalence of high blood pressure (BP) was 11.6%. The non-modifiable risk factors that predicted high BP were district of residence (Adjusted odds ratio [AOR] = 0.328, 95% confidence interval [CI] = 0.328-0.203), age (AOR = 1.540, 95%CI = 1.240-1.913), relationship status (AOR = 1.960 95%CI = 1.059-3.628) and possessing a phone (AOR = 0.538, 95%CI = 0.325-0.890). The modifiable risk factors that predicted high BP were high BMI, not checking BP regularly, and not having an awareness of salt intake. In accordance with these results, prevention programs must focus on adolescent knowledge, lifestyle practices, and attitudes toward control measures. It is important to incorporate health education in school curricula to promote a healthy lifestyle and limit the risks associated with high BP.

Factors influencing cancer patients' caregivers' burden and quality of life: An integrative review.

This integrative review assessed the factors influencing cancer patients' caregivers' burden and quality of life (QoL). Relevant studies were retrieved from five electronic databases and screened. After systematic screening by title, abstract, and full text, the review included 15 studies published between 2000 and 2022 and used an interpretive thematic synthesis design for analysis. Age (older), sex (male), high work requirements, relationships with patients, low-income levels, high subjective stress, patient dependency level, and trait anxiety were significantly associated with higher caregiver burden. Factors associated with the low QoL of caregivers were age (less than 35 years), caregiving role (more responsibility), relationship with patients (first-degree relative), low income, living in the same home with the patient, and higher social and family responsibilities. A moderate negative correlation (n = 6) was identified between the sum of the QoL scores and the burden. Future research should be integrated into identifying appropriate means to support caregivers of patients with chronic diseases, including cancer by segregating interventions to target specific caregiver populations.

Social determinants of health of racial and ethnic minority adolescents: An integrative literature review.

Integration of adolescents with diverse cultural backgrounds into the country of residence is associated with some form of rejection and discrimination, predisposing them to undesirable health outcomes. In this regard, the aim of this study was to identify the social determinants of the health of racial and ethnic minority adolescents. In this integrative literature review, PubMed, EMBASE, Cochrane Library, and CINAHL databases were searched from 2016 to 2021 and studies were selected according to the PRISMA 2020 guidelines. Health status was limited to health outcomes according to the definition proposed by the World Health Organization and Healthy People 2020. The social determinants of health were classified according to the research framework of the National Institute on Minority Health and Health Disparities. Six types of health status were identified: self-rated health, obesity and overweight, global self-worth, emotional well-being, anthropometric measurement, and psychosocial adjustment. The social determinants of health were at the individual and interpersonal level, and the domains included the biological (gender, illness experience), psychological (acculturative stress), and sociocultural environment (e.g., socioeconomic status, parents' educational level, household death due to violence). Therefore, future research must prioritize their sociocultural environments to reduce the negative impact of discrimination and sociocultural and structural differences on racial and ethnic minority adolescents.

The factors that are associated with nurse immigration in lower- and middle-income countries: An integrative review.

AIM: This study aims to synthesize the factors associated with nurse emigration from lower and middle-income countries. DESIGN: Integrative review. METHODS: An in-depth search of registries and five databases yielded 9466 records. Using the PRISMA guidelines, 11 were chosen after screening by two authors independently. The mixed methods appraisal tool (MMAT) was used to assess the risk of bias. RESULTS: The destination countries were Europe and North America, with an inclination for nurse migration of 14.3%-85%. Emigration factors were poor salary, working conditions, poor quality  healthcare infrastructure; outdated healthcare technologies, lack of employment opportunities, younger age, relationship status (single), living environment, social pressure, urban residence, work experience, insecurity, high crime rates, political corruption and foreign language skills. PUBLIC CONTRIBUTION: Healthcare authorities and nursing leaders must implement practical measures to minimize nurse emigration.

Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study.

BACKGROUND: The Basic Health Care Provision Fund (BHCPF) is a direct financial investment that funds Primary Healthcare (PHC) to improve the quality of services. This study assessed the influence of the BHCPF in improving PHC services. METHODS: A descriptive cross-sectional study was conducted among PHC workers in 100 facilities randomly selected from the 484 designated PHCs for implementing the BHCPF project in Kano state. Using multiple sampling methods, 200 healthcare workers in PHC facilities were selected and assisted by trained data collectors to respond to the questionnaires. Chi-square analysis was used to show associated factors, while binary regression analysis was used to determine the relationship between factors influencing the BHCPF implementation in PHC. RESULT: The findings showed healthcare workers had higher awareness (61.7%) and good utilization (57.1%) of BHCPF. Challenges of the BHCPF implementation were insufficiently skilled health professionals (85%), lack of data management capacity (52.6%), low community participation and awareness (52.0%), delay in releasing funds (60.7%), poor infrastructure (87.8%), and weak financial management and accountability system (58.2%). Healthcare professionals having a diploma were four times more likely to have the National Health Management Information System (NHMIS) in their facilities (AOR = 4.955, 95% CI = 1.120-21.036; P-value 0.035) than those without. Primary healthcare facilities were two times more likely to have the NHMIS (AOR = 2.549, 95% CI = 1.167-5.566: P-value 0. 019) than health post. CONCLUSION: The factors that influenced PHC facilities to promote the implementation of BHCPF included: periodic evaluation of the facilities, availability of functional storage facilities, and improving the standard of care in PHC facilities. There is a need for retraining healthcare workers and creating more community awareness of the BHCPF.

The relationship between trust, belief and adherence among patients who complain of hypertension in Ghana.

AIM: We determined the relationship between trust, belief and adherence among patients who complain of hypertension in Ghana. DESIGN: A cross-sectional design was used. METHOD: We sampled 447 Ghanaians with hypertension receiving care at the Korle Bu Teaching Hospital. Data were collected using a pre-tested self-administered questionnaire. Data analyses were conducted with the aid of Stata 15.0. RESULTS: There is low belief and trust in the biomedical treatment for hypertension. Only 36.9% of the respondents said they adhered to treatment with females expressing higher level of adherence. Trust and belief in allopathic care were associated with adherence to treatment. It is recommended that health workers identify effective ways of improving patients' trust in the allopathic care for hypertension through teaching and re-enforcement models to enhance treatment adherence and reduce the complications of hypertension. Patient or Public Contribution.

Hypertension literacy: Concept analysis.

AIM: Analysis of the concept of hypertension literacy to ensure clarity, reduce ambiguities and promote consistency in usage. DESIGN: Walker and Avant's concept analysis method was adopted. METHODS: Searched four electronic databases using keywords combined with the appropriate Boolean operators. After removing duplicates, thirty titles were identified, and ten articles met the basic criteria for inclusion. The analysis was done using a convergent synthesis design to integrate results and transform them into qualitative descriptions. RESULTS: Hypertension literacy's defining attributes were hypertension information search skills, comprehension of numeracy associated with blood pressure and medication and utilization of hypertension prevention information. The identified antecedents were formal education and improved cognitive, social, economic and health-related experiences. Consequences of hypertension literacy included improved self-reported and increased health awareness. Hypertension literacy allows nurses to assess and accurately improve knowledge and facilitate people to adopt prevention behaviours.

Students' experiences of sexual harassment; a descriptive cross-sectional study in a college of education, Ghana.

Introduction: Sexual harassment is a component of gender-based discrimination that indicates unequal power relations and affects students' psychological and physical well-being and academic achievement. This study assessed students' experiences of sexual harassment at the Offinso College of Education. Methods: This cross-sectional descriptive study incorporated a whole population sampling of second and third-year female students to respond to a pre-tested questionnaire uploaded on Google Forms. The data were vetted for appropriateness, cleaned in Microsoft Excel, and transferred to IBM Statistical Package for Social Sciences for analysis into descriptive statistics and chi-square tests of associations. Results: The study indicated that women (66%) had previously had sex before admission into college and perceived that they were at risk of sexual harassment (43.0%). It was statistically significant that the student's level of education was associated with the experience of being sexually harassed (χ2 = 10.950, p-value <0.00) and the perception that sexual harassment was a problem among students (χ2 = 13.376, p-value <0.01). The nature of the female students' marital relationships was statistically significant (χ2 = 11.209, p-value<0.02) to the perception of sexual harassment as a problem in the college. Conclusion: Female students must have adequate education on the sexual harassment policy of the institution and measures put in place to identify and provide appropriate sanctions to issues of sexual harassment at the college education level.

Factors related to readiness for practice among undergraduate nursing students: A systematic review.

AIM: This systematic review identifies the factors and effective strategies related to nursing students' readiness for practice. METHOD: A search was conducted from 2012 to 2022 in PubMed, CINAHL, SCOPUS, PsycInfo and EMBASE databases, using a combination of predetermined keywords. Four authors made the selection independently and the methodological quality was assessed using the RoBANS, Analytical cross-sectional studies Critical Appraisal Tool and MMAT tools. Information was extracted using a matrix and analyzed through the thematic synthesis approach. RESULT: Studies (14,000) were identified from the search and 11 met the predetermined inclusion criteria. The main identified themes were personal characteristics, education-related factors, cognitive factors, psychological characteristics and social factors influencing readiness to practice. Some barriers also affect readiness for practice among undergraduate nursing students. CONCLUSION: Multiple personal, educational and community factors interact in diverse ways to influences nursing students readiness to practice. REGISTRATION: The protocol for the conduct of this study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020222337.

Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: a national population-based cross-sectional survey.

BACKGROUND: Breast cancer is a leading cause of cancer mortality and a major public health problem. The growing number of breast cancer-related deaths has been largely attributed to a lack of awareness of the disease among women. Whilst there have been frequent campaigns promoting breast cancer awareness, evidence suggests that women still lack awareness. Therefore, this study assessed the prevalence and factors associated with the awareness of breast cancer among women of reproductive age in Lesotho. METHODS: We used population-based cross-sectional data from the 2014 Lesotho Demographic and Health survey. A total of 6,620 women of reproductive age were included in the analysis. The outcome variable was awareness of breast cancer. Women who heard about breast cancer were considered to be aware of the disease. Multilevel binary logistic regression models were fitted to determine the factors associated with breast cancer awareness among women. RESULTS: The level of awareness of breast cancer was 86.8% (95% CI: 85.5, 87.9). Women aged 45-49 years [adjusted odds ratio (AOR) = 2.87, 95% confidence interval (CI): 1.83, 4.48], married women [AOR = 1.51 (95% CI: 1.19, 1.93)], and women with higher educational level [AOR = 12.56, (95% CI: 4.35, 36.28)] were more likely to be aware of breast cancer. Additionally, women who listened to the radio at least once a week [AOR = 1.96, (95% CI: 1.63, 2.37)], those who read newspapers or magazines [AOR = 1.91 (95% CI: 1.48, 2.46)] and women in the wealthiest group [AOR = 2.55, (95% CI: 1.67, 3.89)] had higher odds of breast cancer awareness. However, women who were in rural areas were less likely [AOR = 0.63, (95% CI: 0.47, 0.84)] to be aware of breast cancer than those in urban areas. CONCLUSION: The level of awareness of breast cancer among women of reproductive age in Lesotho was extremely low. We recommend that policymakers, clinicians, and public health practitioners should consider the factors identified in this study when designing and developing intervention programs to improve the awareness of breast cancer among women in Lesotho.

Determinants of Self-Care and Home-Based Management of Hypertension: An Integrative Review.

Introduction: Patients with hypertension should perform diverse self-care activities that incorporate medication adherence and lifestyle modification, such as no smoking or alcohol, weight reduction, a low-salt diet, increased physical activity, increased self-monitoring, and stress reduction, for effective management at home. Aim: This systematic review assessed and synthesized the factors that are associated with self-care and home-based management of hypertension. Methods: The search of the articles incorporated the population, intervention, comparison, and outcome (PICO) framework. The literature was searched in four databases (PubMed, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, and Web of Science) until 2022. The articles retrieved and searched from the reference list (531) were transported to EndNote version 20, and duplicates (19) were identified and removed to produce 512 titles. Following the eventual title, abstracts, and full-text screening, 13 articles were appropriate for this study. The narrative and thematic data analysis were used to analyze and integrate the data. Results: The analysis showed five themes were associated with home-based self-care and blood pressure (BP) control among patients diagnosed with hypertension. These themes that emerged were (1) the prevalence of control of BP, (2) sociodemographic factors, (3) treatment-related factors, (4) knowledge of management, and (5) knowledge of the prevention of risk factors of hypertension. The demographic factors influencing home-based self-care for hypertension were gender, age, and socioeconomic status. In contrast, the treatment factors were duration of hypertension treatment, medication burden, and medication adherence. Other factors that influenced self-care were inadequate knowledge of BP management, follow-up care, and risk factors of hypertension. Conclusion: Hypertension self-care interventions must incorporate individual, societal, and cultural perspectives in increasing knowledge and improving home-based hypertension management. Therefore, well-designed clinical and community-dwelling interventions should integrate personal, social, and cultural perspectives to improve behavior in the home management of hypertension by increasing knowledge and self-efficacy.

Family-centered interventions for children and adolescents with type 1 diabetes mellitus: an integrative review.

PURPOSE: The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM). METHODS: A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM. RESULTS: From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technologybased interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parentchild teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression. CONCLUSION: Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.

Prevalence and determinants of medication adherence among patients taking antihypertensive medications in Africa: A systematic review and meta-analysis 2010-2021.

AIM: This study synthesized the prevalence and determinants of hypertension medication adherence. DESIGN: Systematic review and meta-analysis through systematic search in PUBMED, EMBASE, CINAHL, Cochrane library and Google Scholar, from 2010 to 2021. METHODS: Screening was conducted and reported according to PRISMA criteria, and ten studies identified according to predetermined criteria. The studies were evaluated using the Mixed Method Appraisal Tool. Analysis was done using the narrative synthesis method. Prevalence data were examined using random effects meta-analysis in Comprehensive Meta-Analysis version 3. RESULTS: The overall prevalence of medication adherence was 34.1%, and determinants of medication adherence were the ability to attain hypertension control; hypertension knowledge; and treatment-related factors including belief of the drug efficacy, having commodities, sociocultural and financial-related factors. It is imperative to develop, test and use a comprehensive hypertension medication adherence tool that is culturally congruent to Africa.

Impact of early palliative care on the quality of life in caregivers of cancer patients: A systematic review.

BACKGROUND: Maintaining caregivers' quality of life (QoL) is critical to sustaining the care needed for cancer patients. One of the interventions applied to cancer patients' caregivers is early palliative care (EPC). AIMS: This systematic review synthesized the implementation of EPC on the QoL of caregivers of cancer patients. METHODS: The search was undertaken using seven electronic databases: Medline, Embase, CINAHL, CENTRAL, Web of Science, Scopus, and ProQuest Dissertation & Theses (PQDT). The search strategy integrated relevant terms of early palliative care, caregivers, cancer, and quality of life and was conducted until March 14, 2022. The thematic data analysis approach was used to integrate the results. RESULTS: Using advanced search features, 4193 studies were obtained on the initial search. After screening and quality assessment, eight studies were included. Eight studies depicted that EPC interventions were delivered for caregivers of patients with advanced cancer, that is, those with a life expectancy of at least 4-24 months or considered intermediate to poor prognosis. One study provided the intervention for caregivers of patients newly diagnosed with cancer. None of the studies had the same protocol or content in delivering EPC for caregivers. Four studies gave similar details on addressing the strategies for caregivers in several aspects, including physical, psychological, social, and spiritual. There was no difference in the QoL between caregivers with cancer patients who received EPC compared with usual care. EPC was noted to influence other factors, such as caregivers' psychological distress and burden. LINKING EVIDENCE TO ACTION: The data on EPC interventions portray no beneficial effects on the QoL of caregivers with cancer patients. Further studies on developing standard protocols of EPC, multidisciplinary team, and how early it should be given to caregivers are strongly recommended.

Risk factors associated with the incidence and prevalence of hypertension in Ghana: an integrated review (2016-2021).

This study synthesized the risk factors associated with hypertension among adolescents and adults in Ghana. A systematic search in four databases between 2016 and 2021 retrieved 119 Ghanaian studies, and through screening, 16 were selected. Thematic analysis was used to synthesize extracted data. Prevalence of hypertension ranged from 13.0% to 28.4% and prehypertension 22.0% to 51.4%. The non-modifiable hypertension risk factors were age, marital status, gender, and residence. The modifiable risk factors were consuming additional table salt, salted meat, alcohol, canned meats, smoking, and psychological factors, including stress and anxiety. Also, higher education and socio-economic status, employment, access to medical insurance, overweight, and higher BMI were risk factors. Targeted, sustained, systematic, and effective intervention programs should target high-risk people.

Challenges and coping strategies of nurses and midwives after maternity leave: A cross-sectional study in a human resource-constrained setting in Ghana.

AIM: This study examined the challenges and coping strategies adopted by nurses and midwives after child birth when they return to work. DESIGN: A cross-sectional design was used. METHOD: Two hundred nurses and midwives with history of maternity leave were recruited from the Korle-Bu Teaching Hospital to take part in this study. Data were collected using a pre-tested self-administered questionnaire. The data were analysed with the aid of Stata 13.0. RESULTS: Most of the respondents claimed that they received support from relatives, day care centres and paid house helps while they resumed work. Seventy percent of the respondents indicated that they were given off day when they needed to send their child for postnatal care. Nurses and midwives depend on family members, paid house helps and day care centres to help them cater for their babies. It is recommended that hospitals set-up day care centres and breastfeeding bays attached to the institutions.

Factors associated with pregnancy uptake decisions among seropositive HIV people receiving antiretroviral therapy in sub-Saharan Africa: A systematic review.

AIM: This study determined the factors associated with pregnancy uptake decision among seropositive HIV people receiving antiretroviral therapy in sub-Saharan Africa. DESIGN: Systematic review. METHODS: The population, intervention, comparison and outcomes framework was adopted to search for literature after a scoping review using the preferred reporting items for systematic reviews and meta-analyses guidelines adopted in searching, and screening articles from four databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Google scholar) to find 12 articles suitable for this study. RESULTS: Motivators of pregnancy uptake among HIV-positive women include desire to have children, knowledge about PMTCT, cultural duty for married women to have children, and household income. Demotivating factors included the modern method of contraception and burden associated with pregnancy. CONCLUSION: There is a need to improve on services that reduce conception-related risks especially for women who choose to conceive and to incorporate fertility-related counselling into HIV treatment services.

Factors Associated with the Implementation of an Improved Community Health Fund in the Ubungo Municipality Area, Dar es Salaam Region, Tanzania.

Community-based health insurance schemes help households to afford healthcare services. This paper describes healthcare facilities and community factors that are associated with the Improved Community Health Fund (iCHF) scheme in the Ubungo district of Tanzania. A cross-sectional descriptive study was conducted using online questionnaires that were completed by healthcare providers and community members in public-owned healthcare facilities in the Ubungo Municipal Council district of Dar es Salaam, Tanzania, between October and November 2021. The data were analyzed using descriptive statistics and the chi-squared test of association. We found a statistically significant relationship between income level and satisfaction with the iCHF scheme. For community-related factors, income level was statistically significant in the level of involvement in iCHF implementation among local leaders. Further, income level was statistically significant in relation to community behavior/culture toward the iCHF. Occupation was statistically significant in iCHF implementation, iCHF premiums, and iCHF membership size. A statistically significant relationship was also found between income, iCHF membership size, and iCHF premiums. Moreover, people would be willing to pay the required premiums if the quality of the healthcare services under the iCHF scheme improves. Therefore, the government should allocate resources to reduce the challenges that are facing iCHF implementation, such as the preference for a user fee scheme over the iCHF, the issues that are faced by enrollment officers, and inadequate iCHF premiums and membership size.

Factors associated with ownership and utilization of insecticide treated nets among children under five years in sub-Saharan Africa.

BACKGROUND: Insecticide-treated net (ITN) is a cost-effective means to control malaria and morbidity in under-five children. This study synthesizes the factors associated with using the ITN as a malaria prevention tool in sub-Saharan Africa. METHODS: There was an advanced search of four electronic databases, including PubMed Central, CINAHL, EMBASE, and Google Scholar, and identified articles between 2016 to April 2021. Following the title, abstract and full-text reading, 13 articles were deemed appropriate for this review. All the researchers developed, discussed, and accepted a matrix to extract relevant information from the studies. A convergent synthesis was adopted and allowed for integrating qualitative, quantitative, and mixed-method studies and transforming them into qualitative findings. RESULTS: Household and caregiver related factors that influenced utilization of the ITN were, Household heads having two or more sleeping places, a knowledge that ITN prevents malaria, the presence of hanging ITNs, high literacy, living female-headed households, birth spacing, unmarried mothers, and antenatal clinic attendance promoted utilization. Perceived malaria risk was a critical determinant of ITN ownership and utilization. Some factors that hindered the use of the ITN included hotness of the weather, absence of visible mosquitoes, cost, inadequate number, rooms designs, unaffordability, insufficient knowledge on causes of malaria, and poor attitude to use. Specific ITN factors that hindered use were color, chemicals use, odor, and shape. CONCLUSION: It is important to use integrated multi-sectoral and culturally appropriate interventions to encourage households to prioritize and utilize the ITN in under-5 children.

Factors associated with motorcycle-related road traffic crashes in Africa, a Scoping review from 2016 to 2022.

BACKGROUND: The toll associated with road traffic crashes (RTC) is high, and the burden of injury is disproportionately borne by pedestrians and motor riders, particularly in developing countries. This study synthesized the factors associated with motorcycle-related RTC in Africa. METHODS: The PICO framework and the PRISMA guidelines for conducting reviews were incorporated in searching, screening, and reporting the findings. Advanced search in five electronic databases (Google Scholar, PubMed Central, Scopus, CINAHL, and Embase) yielded 2552 titles and 22 from manual search, filtered for 2016 to 2022 (to generate 1699) and then further for primary studies (854). Through the title, abstract and full-text screening, 22 were appropriate for this review. Data extraction was done by the two researchers independently, and the results were compared. Convergent synthesis was adopted to integrate results, transformed into a narrative, and analyzed using thematic synthesis. RESULTS: The four main themes identified were the rider-related, non-rider-related factors, prevalence and severity of injuries from RTC, and the measures to reduce RTC. The behavioral factors associated with RTC were alcohol use, smoking, use of illicit drugs, tiredness of rider, poor knowledge on traffic regulations, more than one pillow rider, lack of rider license, non-observance of traffic regulations, and non-use of personal protective equipment. Road traffic crashes were common among younger age and male gender. Other factors identified included poor road network, unplanned stoppage by police, unlawful vehicular packing, increased urbanization, and slippery floors. CONCLUSION: There is the need to institute multi-sectoral measures that target riders' behavior change. Coordinated efforts should target governments, enforcement authorities, and regulatory bodies to enforce enactment that ensures safe use of roads.